I make this claim not in the way that the Democratic Alliance has instrumentalised the virus and turned it into a cause (everything-the-government-says-or-does-is-necessarily-wrong).

The point I want to drive home is that funerals may turn into superspreaders. And, it should be said, there are religious rituals that may widen this spread. In some religions and cultures the dead are kissed and touched and “displayed” for families and friends to “see” them and recite prayers. We cannot let death spread further than it already has. While the dead are, well, dead and nothing else remains, life is more sacred than the economy – never mind what homo economicus may say.

Anyway, looking back over the past year the abiding images are the mass graves in Iran that were so vast they were visible from space, and images of mass burials on Hart Island in New York City. The site has a long history of mass burials, and burials of indigents or people whose bodies have not been identified or claimed. It has now become the burial place for masses of people who have died from Covid-19. These images were somehow evocative of the catacombs of Paris and Rome. It’s just as well we are far from those burials in Iran, Brazil and New York City – for now.

This is a short clip of mass burials in Iran. This is Brazil.

All of this ruminating brings up the question of what happens to all the bodies, and resultant complications. The number of deaths in South Africa is low – 26,735 at the time of writing. While land is still relatively inexpensive here and there are very many below-ground burial spaces on the outskirts of cities, there should be no problem with burials. It would be safest, of course, if the dead were simply cremated to minimise the spread of the disease from the dead to the living. Personally I would like to be buried, so the worms and maggots can eat my corpse (the way I have eaten plants and animals during my life) and complete the natural cycle.

Don’t touch me on my dead

However, the very idea of cremation will probably upset serious religious groups. Some prefer to wash the dead and put them on “display” at prayer services before taking them to their final destination. It is against Muslims’ beliefs to cremate bodies. Most recently, in Sri Lanka, it was reported that 15 Muslims, including a 20-day-old baby, were cremated “against family wishes and funeral rites laid out in Islam”.

These are, however, strange and exceptional times. There are places around the world (New York, Iran, Iraq, Brazil, Sri Lanka, etc) where people of all religions are buried in sites created for Covid-19 victims. For instance, Reuters reported that in Iraq, medical staff and volunteers bury between two and four bodies a day, and grapple with the differences between Muslim and Christian burial rites. In some ways cremation is the “easiest”, in that you get rid of the infected body. I should say, at this point, and more below, that there is insufficient evidence that the dead carry the virus, but it is best to err on the side of caution.

When the British government initially (in March) proposed “mandatory cremations” the Jewish and Muslim communities were offended. The head of Britain’s Jewish Board of Deputies, Marie van der Zyl, requested that the government respect religious traditions on burials.

“For those that do succumb to this pandemic, it is important that they know that they will be laid to rest in accordance with their wishes,” she said. We do, however, live (and die) in unusual times… ”

Under pressure from Jewish and Muslim citizens, the government made an almost immediate about-turn, and amended the bill that called for mandatory guidelines. By December, cases in the UK rose to 2.3 million, and deaths rose to just under 73000. It may be impossible to convince Muslim or Jewish families of the benefit of cremation, let alone anonymous burials wrapped in plastic.

By December, the UK government published new guidelines “to ensure that: bereaved people are treated with sensitivity, dignity and respect [and that] funerals can continue to take place while minimising the risk of infection”, with the caveats that the guidelines remain under review and that no more than 30 people are allowed to attend a funeral, “whether indoors or outdoors”. 

Insufficient evidence of dead-to-living transmission

The pandemic has changed burial rituals across religions. In India, Hindus have, for centuries, burned corpses on funeral pyres along the Ganges River. Jews traditionally received condolences at home during a seven-day mourning period. Muslims gathered to wash the corpses of loved ones. But “global burial rituals are being dramatically changed”.

This raises several questions. Is it really necessary to summarily, and without religious rituals, cremate or anonymously bury people who died of Covid-19? Well, if you err on the side of caution (and don’t care for religious rituals) the answer is a simple yes. If, however, you want to allow, say, Christians, Muslims and Jews to take possession of the body, there may be the risk of infecting their families. This brings up another question: Can someone be infected by a corpse?

There is no straightforward answer, which makes it easier to err on the side of caution. What we do know is that traditional funeral practices around the world, and among most religions, have been disrupted. Muslim and Jewish practices and rituals have been especially upended. Governments around the world have focused more on reducing (living) person-to-person transmission, as well they should.

Corpse management in the age of Covid-19 remains a mystery – nobody seems to have a straight answer as to how long the virus remains active after the carrier has died. At this point there is very little scientific literature (I searched through countless medical journals available online over a few hours and found only a single related research article) on the post-mortem risks of Covid-19. The Journal of Forensic and Legal Medicine published an article in May (Covid-19 in forensic medicine unit personnel: Observation from Thailand) that reported a likely infection directly or indirectly from a deceased person.

Either way, as we count the dead in South Africa – and given the flouting of regulations across the country – we should probably keep contact between the living and those who have died from Covid-19 to a minimum.

We have come a long way, in terms of science and technology, since the Spanish flu when mass mortality led to macabre scenes of bodies. In the US, Red Cross nurses in Baltimore “reported instances of visiting flu-ravaged homes to discover sick patients in bed beside dead bodies. In other cases corpses were covered in ice and shoved into bedroom corners where they festered for days. Inundated undertakers stacked caskets in funeral home hallways and even in their living quarters.”

Closer to home, during the Ebola epidemic in West Africa, the virus remained highly contagious after a person’s death. Traditionally, burial customs in parts of West Africa involve family members washing, touching, and kissing the bodies, thereby significantly increasing the risk of transmission. In 2015, the World Health Organisation estimated that “at least 20% of new Ebola infections occur during burials of deceased Ebola patients”. It was reported in 2014 that the Ebola virus was transmitted to others during a burial in Guinea.

We are a long way from the mass burials on New York’s Hart Island. We are longer away still from the ossuaries of Paris and Rome’s catacombs. If we are to reduce infections, and have families play a role or show respect to their dead relatives, it may do no harm, in some instances, to ask families help dig graves – as a sign of respect and of involvement in putting relatives to rest – and turn to dry ablutions before burials. This could minimise touching, washing and kissing bodies. Until there is firm evidence that the virus dies after it has killed a person, it may be better to avoid all contact with the deceased. Then again, all of this may be moot. DM