How are Malaysia’s forensic teams coping with Covid-19 body backlogs?

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Forensic Teams Grapple with Overwhelmed Capacity Amidst Rising Covid-19 Fatalities

Malaysian forensic teams are experiencing significant strain due to escalating Covid-19 fatalities, leading to backlogs in managing deceased individuals. The National Institute of Forensic Medicine (IPFN) at Kuala Lumpur Hospital (HKL) is particularly affected, with existing morgue facilities proving insufficient. This has necessitated the use of repurposed shipping containers as temporary morgues, each capable of holding between 12 to 20 bodies of Covid-19 patients.
Makeshift Morgues and Limited Storage Capacity

The surge in deaths has pushed the IPFN morgue beyond its typical capacity of 36 bodies. To accommodate the overflow, additional storage spaces have been secured at Tunku Azizah Hospital, which can hold up to 10 bodies, the Tuanku Mizan Armed Forces Hospital with a capacity for four, and the National Cancer Institute with space for two. A reserve of 52 coffins and backup containers are also on hand to manage the situation.
Strained Cremation Services and Extended Processing Times

Cremation services, particularly within the Klang Valley, face their own bottlenecks, with only one facility managed by Kuala Lumpur City Hall (DBKL) available for both Covid-19 and non-Covid-19 cases. This leads to considerable waiting times for the cremation of Covid-19 victims. The cremation process itself for Covid-19 cases is also more time-consuming, taking two to three hours compared to the 45 minutes to an hour for non-Covid-19 remains, primarily due to the requirement of using two layers of body bags for safety.
Increasing Brought-in-Dead Cases and Shifting Demographics

A significant concern for forensic teams is the sharp rise in brought-in-dead (BID) cases directly attributed to Covid-19. While the first wave saw only one to two such cases per month, recent daily figures have reached three to four. This trend is accompanied by a worrying shift in victim demographics, with younger individuals in their 20s and those without pre-existing health conditions increasingly succumbing to the virus, potentially due to viral mutations and variants.
Modified Post-Mortem Procedures and Staff Fatigue

To mitigate the risk of infection to staff, modified post-mortem procedures are being employed for BID or suspected Covid-19 cases. Computed tomography (CT) scanning is utilised to assess the lungs and other organs, allowing for external checks and an assessment of conditions like pneumonia without performing a full autopsy. Despite these adaptations, forensic staff are reporting extreme fatigue, with some handling as many as 15 cases in a single night. Many family members are also unable to be present for the final rites due to quarantine restrictions, adding emotional distress to the already challenging operational circumstances.

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How are Malaysia’s forensic teams coping with Covid-19 body backlogs?

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