LitCovid-sentences  

PMC:7148714 / 5405-23628 JSONTXT 13 Projects

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Id Subject Object Predicate Lexical cue
T29 0-113 Sentence denotes 2 Management of the dead associated to COVID-19, Technical Recommendations for Healthcare and Death Care workers
T30 114-449 Sentence denotes This part provides guidance on the measures required for effectively assisting in the management of the large numbers of dead from COVID-19 that may likely need an increase of the necessary human and material resources, including for building local capacity and supporting and/or carrying out the recovery and identification processes.
T31 451-492 Sentence denotes 2.1 Important considerations of COVID-19
T32 493-608 Sentence denotes SARS-CoV-2, the virus which causes COVID-19, is classified as a HG3 (hazard group 3) pathogen (such as HIV and TB).
T33 609-705 Sentence denotes In some infected people it may cause a severe and acute respiratory syndrome which can be fatal.
T34 706-812 Sentence denotes There is presently still no vaccine or effective cure for COVID-19 infection and treatment is symptomatic.
T35 813-1051 Sentence denotes The virus is known to spread mainly person-to-person:• Through respiratory droplets and fomites [4] produced when an infected person coughs or sneezes, between people who are in close contact with one another (within about 2 m or 6 feet).
T36 1052-1141 Sentence denotes Infective aerosol and droplets may also be produced from splashes of contaminated fluids.
T37 1142-1347 Sentence denotes • Infection is also possible from contact with contaminated surfaces or objects by touching a surface or object that has the virus on it (e.g. fomites) and then touching own mucosa of mouth, nose, or eyes.
T38 1348-1468 Sentence denotes The virus is known to normally survive a few hours outside the host, but this may extend to days in some conditions [6].
T39 1469-1750 Sentence denotes Working in environments overcrowded with people infected with COVID-19 is a risk factor (e.g. collecting the dead from an overcrowded detention facility), for which the personal protective equipment (PPE) recommended in this guidance provides adequate protection, if properly used.
T40 1751-1877 Sentence denotes The virus is easily neutralized with water and soap and with standard disinfectants, such as bleach and ethanol solutions [6].
T41 1878-2433 Sentence denotes Any post-mortem activities, from recovery, transport, to autopsies and handover to families and burial, should be therefore conducted with a focus on avoiding aerosol generating procedures, such as splashes of contaminated fluids; and ensuring that if aerosol generation is likely (e.g. when using an oscillating saw, which is NOT recommended) that appropriate engineering controls and PPE are used and that the disinfection of contaminated surfaces and equipment, together with thorough personal hygiene, especially hand-washing, are rigorously observed.
T42 2434-2736 Sentence denotes These precautions and the use of standard precautions such as those recommended in this guidance should ensure that appropriate work practices are used to prevent direct contact with infectious material, percutaneous injury, and hazards related to moving heavy remains and handling embalming chemicals.
T43 2738-2820 Sentence denotes 2.2 General principles for the management of human remains infected with COVID-19
T44 2821-3002 Sentence denotes • Any activity undertaken in relation to the management of known or suspected COVID-19 fatalities must be preceded by a preliminary evaluation and risk assessment (see section 3.1).
T45 3003-3201 Sentence denotes • Staff undertaking recovery and identification of human remains infected or suspected to be infected with COVID-19 must be specifically trained for the task of managing the dead and the use of PPE.
T46 3202-3388 Sentence denotes The operation should be supervised by suitably qualified staff, at the minimum a forensic professional trained and experienced in the management of the dead in challenging circumstances.
T47 3389-3701 Sentence denotes • The procedures adopted must seek to limit the potential for staff exposure to COVID-19, prevent as far as is possible the spread of COVID-19 resulting from the process, allow for the timely and accurate recovery and identification of the human remains and ensure the dignity of the dead throughout the process.
T48 3702-3979 Sentence denotes • The management of large numbers of dead bodies requires that all necessary measures be adopted to ensure their documentation and traceability throughout, from recovery to storage and final disposal, to avoid their loss or misplacement and/or of the corresponding information.
T49 3980-4080 Sentence denotes Special procedures should be put in place for the management and protection of the data on the dead.
T50 4081-4426 Sentence denotes • Where potential conflict arises between existing cultural practices and additional safeguards to prevent further exposure and propagation of the virus, the latter must take precedent and efforts should be made for ensuring that this is understood, accepted and supported by the concerned community or religious authorities and the next of kin.
T51 4428-4476 Sentence denotes 2.3 Technical recommendations for body handlers
T52 4477-4568 Sentence denotes "Body handler" refers to any individual involved in the physical handling of human remains.
T53 4569-4962 Sentence denotes This includes, but is not limited to, healthcare practitioners and healthcare assistant personnel, death care workers including forensic doctors, pathologists and other forensic experts, autopsy technicians, non-forensic personnel charged with recovery and transportation of human remains, individuals involved in body preparation for body disposal, for funerals or other commemorative events.
T54 4963-5299 Sentence denotes Body handlers should take precautions when handling the remains of individuals that have died from COVID-19.• Use of standard PPE – Gloves (Ensure that gloves are unpunctured, nitrile gloves preferred)/aprons/long sleeved gowns/overalls to protect skin and clothing from contamination by infected material/Face masks and eye protection:
T55 5300-5550 Sentence denotes Googles or face shields/Full-face masks: FFP3 masks or N95 respirators are currently considered best for preventing inhalation of aerosols and in case of splashes during the body handling process to protect the face, eyes, nose, and mouth (Table 1 ).
T56 5551-5597 Sentence denotes Table 1 Transmission based precautions (TBPs):
T57 5598-5680 Sentence denotes Personal protective equipment (PPE) for care of deceased during COVID-19 pandemic.
T58 5681-5883 Sentence denotes Table adapted from guidance developed by Department of Health and Social Care, Public Health Wales, Public Health Agency (PHA) Northern Ireland, Health Protection Scotland and Public Health England [7].
T59 5884-6115 Sentence denotes Low risk Procedures∗:Admission of deceasedPreparation for viewingRelease of deceased Medium risk Procedures∗∗:Rolling deceasedUndressing deceasedSignificant manual handling High risk Procedures:Autopsy and other invasive procedures
T60 6116-6145 Sentence denotes Disposable gloves Yes Yes Yes
T61 6146-6182 Sentence denotes Disposable plastic apron Yes Yes Yes
T62 6183-6208 Sentence denotes Disposable gown No No Yes
T63 6209-6266 Sentence denotes Fluid-resistant (Type IIR) surgical mask (FRSM) Yes No No
T64 6267-6317 Sentence denotes Filtering face piece (FFP)∗∗∗ No FFP2 or FFP3 FFP3
T65 6318-6355 Sentence denotes Disposable eye protection Yes Yes Yes
T66 6356-6442 Sentence denotes Protective footwear (e.g. rubber boots which can be disinfected after use) Yes Yes Yes
T67 6443-6516 Sentence denotes ∗If procedure likely to cause droplet contact, use medium risk procedure.
T68 6517-6730 Sentence denotes ∗∗If procedure likely to generate aerosols, use high risk procedure. ∗∗∗ECDC (European Centre for Disease Prevention and Control) recommends the use of FFP3 masks for performing aerosol-generating procedures [15].
T69 6731-6918 Sentence denotes In case of shortage of Class 3 respirators, the use of Class 2 respirators (e.g. FFP2) may be considered, on a case by case basis and after assessing the risks of the procedures required.
T70 6919-7021 Sentence denotes • Shoe protection is desirable, ideally consisting of rubber boots which can be disinfected after use.
T71 7022-7155 Sentence denotes • If there is a risk of cuts, puncture wounds, or other injuries that break the skin, wear heavy-duty gloves over the nitrile gloves.
T72 7156-7241 Sentence denotes • Where possible use double body bags or body bags for infectious cases if available.
T73 7242-7354 Sentence denotes • Disinfect any non-disposable equipment being used during the handling of the remains as per standard practice.
T74 7355-7472 Sentence denotes • Used PPE should be properly disposed of to avoid contact with people, food, drink, or eating and drinking utensils.
T75 7473-7513 Sentence denotes Biohazardous waste incineration is best.
T76 7514-7634 Sentence denotes • Avoid contact with your face and mouth, as well as food, drink, or eating and drinking utensils, during body handling.
T77 7635-7711 Sentence denotes • Rigorously wash hands after body handling and prior to eating or drinking.
T78 7712-7798 Sentence denotes • Do not engage in any other activity during the body handling or preparation process.
T79 7799-7951 Sentence denotes • Following the body handling or preparation process, rigorously wash hands and disinfect surfaces that may have come in contact with the infected body.
T80 7952-8081 Sentence denotes • Be aware of any hazards, in addition to COVID-19, which may be present in the environment and site of the location of the body.
T81 8082-8223 Sentence denotes • Ensure that any potentially contaminated staff clothing is not taken to their place of residence or those of others before proper cleaning.
T82 8224-8416 Sentence denotes • The potential for COVID-19 in human remains continues to pose a cross contamination hazard for some time after they have been removed from the site of recovery (hours and possibly days [6]).
T83 8417-8518 Sentence denotes • Similarly, personal effects of the deceased may also continue to pose a cross contamination hazard.
T84 8519-8716 Sentence denotes If they are to be returned to next of kin, careful consideration must be given to an appropriate means of decontamination to ensure that the health of those receiving these items is not endangered.
T85 8717-8896 Sentence denotes • Similarly, documentation created during the recovery, transport, examination, storage and burial process may become infected with COVID-19 and should be disinfected accordingly.
T86 8897-9063 Sentence denotes • The process of recovering and identification of human remains of COVID-19 fatalities will generate waste products which are also potentially infected with COVID-19.
T87 9064-9247 Sentence denotes Careful consideration must be given to safe management and disposal of this waste to ensure that the safety of those involved is not compromised and the spread of COVID-19 is avoided.
T88 9248-9373 Sentence denotes • Transport the body to the mortuary (or disinfection location if no post-mortem examination will occur) as soon as possible.
T89 9375-9423 Sentence denotes 2.4 Considerations for post-mortem examinations
T90 9424-9545 Sentence denotes Deaths known to be caused by COVID-19 are natural deaths and in general would not require a full-post mortem examination.
T91 9546-9758 Sentence denotes However, this may be required in certain circumstances (e.g. deaths in custody [8]) or when other factors are suspected (e.g. accident, suicide, homicide) regardless of the COVID-19 status of the deceased person.
T92 9759-10019 Sentence denotes The decision for carrying out a full or partial post-mortem examination is normally the responsibility of the jurisdictional authority in charge (e.g. coroner, prosecutor, judge), sometimes after discussions with the investigators and forensic medical doctors.
T93 10020-10235 Sentence denotes If there is no need for autopsy in COVID-19 suspected cases, sampling technique used to confirm the cause of death is identical to the one used for making diagnosing of COVID-19 suspected cases for patients [20,21].
T94 10236-10553 Sentence denotes For conducting autopsies, in addition to the above the following PPE is recommended: double surgical gloves interposed with a layer of cut-proof synthetic mesh gloves, fluid-resistant or impermeable gown, waterproof apron, goggles or face shield and FFP3 masks or NIOSH-certified disposable N-95 respirator or higher.
T95 10554-10722 Sentence denotes For further guidance, see the briefing issued by The Royal College of Pathologists [[9], [24]], as well as that from a consortium of Italian forensic pathologists [22].
T96 10723-10910 Sentence denotes When possible, appropriate designed rooms with proper ventilation should be used for the examination, to minimize the risk for transmission of airborne pathogens as much as possible [19].
T97 10912-10972 Sentence denotes 2.5 Special considerations in case of non-identified bodies
T98 10973-11444 Sentence denotes Where required the forensic procedures recommended by the ICRC for the identification of the dead are applicable to the identification of those infected with COVID-19 [[16], [17], [18]], with certain caveats as follows:• Remains infected with COVID-19 with persistent agent may pose a cross contamination hazard to unprotected people hence visual recognition by next of kin should be strictly controlled and follow the necessary precautions, including the wearing of PPE.
T99 11445-11658 Sentence denotes Furthermore, due to the likely complexity of the recovery operation and the greater time taken, remains may have decomposed beyond the point where visual recognition is of any value by the time they are recovered.
T100 11659-11827 Sentence denotes • All those involved in the examination and identification process of human remains known or believed to be infected with COVID-19 are required to wear appropriate PPE.
T101 11828-11924 Sentence denotes This PPE has an impact on the wearer’s dexterity and their ability to perform fine motor skills.
T102 11925-12031 Sentence denotes In addition, the performance of invasive techniques may increase the risk to staff of cross contamination.
T103 12032-12118 Sentence denotes For these reasons, the use of invasive techniques should be avoided wherever possible.
T104 12119-12348 Sentence denotes • The extra safeguards required for the handling of infected remains potentially increases the time required to perform the identification and post mortem process as well as the physiological burden on the staff undertaking them.
T105 12349-12492 Sentence denotes • Where it is decided to conduct identification (and post mortem examination), this should also be conducted within the temporary holding area.
T106 12493-12649 Sentence denotes This will help avoid overwhelming and contaminating normal mortuary facilities and endangering their staff, which will be expected to run business as usual.
T107 12651-12706 Sentence denotes 2.6 Special considerations for temporary holding areas
T108 12707-12907 Sentence denotes The purpose of the temporary holding area is to serve as a place where recovered bodies and human remains infected with COVID-19 can be safely stored until arrangements can be made for their disposal.
T109 12908-13147 Sentence denotes Where recovered bodies and human remains continue to pose a risk of cross contamination, staff working in the temporary holding area (including those involved in the identification and post mortem process) must wear appropriate PPE always.
T110 13148-13230 Sentence denotes Attention must be paid to contamination control within the temporary holding area.
T111 13231-13453 Sentence denotes Dependent on the type and persistency of agent to which the remains have been exposed, it may be necessary to undertake some or all the following steps:• Disinfection of body bags upon arrival at the temporary holding area
T112 13454-13530 Sentence denotes • Placing of original body bag containing the remains inside of a second bag
T113 13531-13616 Sentence denotes • Disinfection of the outer bag following the identification or post mortem procedure
T114 13617-13770 Sentence denotes • Wearing of two layers of gloves (the outer pair being nitrile gloves) by all personnel when handling body bags or remains to reduce cross contamination
T115 13771-13918 Sentence denotes • If the case has been tested positive to COVID 19, the body bag should be clearly and permanently labelled, such as: “COVID-19 – Handle with care”
T116 13919-14095 Sentence denotes • Records should be kept of all movements of human remains within the temporary holding area and strict adherence to health and safety protocols should be ensured at all times.
T117 14096-14232 Sentence denotes There must also be a continuous means of communication between the temporary holding area and the team coordinating the overall process.
T118 14234-14314 Sentence denotes 2.7 Special considerations for final disposal of remains/hand over to relatives
T119 14315-14630 Sentence denotes • Decisions on the final disposal of bodies and human remains infected with COVID-19 will vary according to local, cultural and religious context, for which there may be a need to consult with relevant stakeholders, particularly religious representatives, to ensure that changes to standard practice are acceptable.
T120 14631-14764 Sentence denotes Transparent conversation with such societal leaders is likely to be essential to sustain trust between authorities and the community.
T121 14765-14993 Sentence denotes • If final disposal is to take place off-site, human remains should be placed in a second outer body bag. (If the human remains have already been double-bagged, the outer bag should be removed and replaced with a new outer bag).
T122 14994-15073 Sentence denotes This outer bag should be thoroughly disinfected prior to release from the site.
T123 15074-15334 Sentence denotes • Cremation of unidentified human remains should be avoided, and burial in single graves is the preferred method of disposal [5], but care must be taken to ensure that run-off from the decomposing human remains is managed so as not to contaminate ground water.
T124 15335-15423 Sentence denotes Bodies should be buried in their respective body bags, regardless of the use of coffins.
T125 15424-15571 Sentence denotes This will help in their future recovery and examination if necessary (e.g. identification) as well as taking care of the disposal of the body bags.
T126 15572-15674 Sentence denotes • Personal belongings of the deceased infected with COVID-19 may present a cross contamination hazard.
T127 15675-15858 Sentence denotes Consideration should be given to decontamination of such possessions prior to handing them over to the next of kin to avoid the spread of contamination and associated risks to health.
T128 15859-16082 Sentence denotes Where it is not possible to decontaminate possessions, careful consideration must be given as to whether it is appropriate to hand such possessions to the next of kin or whether they should be stored for later safe release.
T129 16083-16236 Sentence denotes If a decision is made to dispose of such objects as contaminated waste, they should be duly documented, together with a justification for this procedure.
T130 16238-16288 Sentence denotes 2.8 Considerations for decontamination procedures
T131 16289-16478 Sentence denotes • Decontamination procedures can be divided into those for the staff undertaking the management of the dead procedures (along with their equipment) and decontamination of the human remains.
T132 16479-16632 Sentence denotes The objectives are to ensure the health and safety of those carrying out the handling of the dead and to prevent the unnecessary spread of contamination.
T133 16633-16852 Sentence denotes • The decontamination approach should be considered as part of the planning process with a view to ensuring the most effective method is adopted, including processes for management of waste generated during the process.
T134 16853-17089 Sentence denotes • The most suitable approach is to place human remains into two body bags at the site of recovery and manage the contamination on the outside of the bag by a combination of contamination monitoring and washing of the outside of the bag.
T135 17090-17450 Sentence denotes • Decontamination of the body is not advisable, mainly because bodies may release inhaled vapor from the respiratory system or other internal contamination via other routes after initial decontamination and vigorous decontamination of bodies or body parts may destroy forensic evidence or obscure identifying marks which may make identification more difficult.
T136 17451-17615 Sentence denotes • The exact method chosen (if any) for decontamination of the body bags should follow the standard procedures for COVID-19 and the use of recommended disinfectants.
T137 17616-17694 Sentence denotes • Decontamination of staff will be as per the method defined for the PPE worn.
T138 17695-17879 Sentence denotes • Upon completion of the process, prior to removal of any equipment from the temporary holding area, care must be taken to ensure that it does not present a cross contamination hazard.
T139 17880-18007 Sentence denotes This will involve monitoring each piece of equipment for contamination and decontamination of equipment as is deemed necessary.
T140 18008-18147 Sentence denotes • Any equipment which cannot be disinfected from COVID-19 must be disposed of as infected waste, following standard biosecurity procedures.
T141 18148-18223 Sentence denotes This usually requires their controlled storage, transport and incineration.