Executive Order No. 29 Series of 2020

“AN ORDER ORGANIZING THE MANAGEMENT OF THE DEAD AND MISSING (MDM) PERSONS FOR PATIENT UNDER INVESTIGATION (PUI) AND CONFIRMED CORONA VIRUS DISEASE 2019 (COVID-19) CASES AND OTHER DISASTER-RELATED CASES, AND PROVIDING GUIDELINES ON THE PROCEDURES IN HANDLING DEATHS IN HOME QUARANTINE AND IN MORTUARIES AND ASSOCIATED ACTIVITIES IN THE CITY OF BISLIG”

WHEREAS, it is a basic human right that every individual deserves a proper and dignified management of his/her remains regardless of creed, ethnicity, race, and religious beliefs;

WHEREAS, Section 2 (j) of RA No 10121 declares it a policy of the state to ensure that disaster risk reduction and climate change measures are gender-responsive, sensitive to indigenous knowledge systems, and respectful of “human rights”;

WHEREAS, the World Health Organization (WHO) declared on 11 March 2020 that the Covid-19 outbreak can now be described as a global pandemic;

WHEREAS, on 17 March 2020, 6:00 PM, President Rodrigo R. Duterte issued Proclamation No. 929, series of 2020 placing the entire Philippines under the State of Calamity for six (6) months unless earlier lifted or extended as the circumstances may warrant;

WHEREAS, as of March 24, 2020, the Department of Health has recorded a total of 606 Patient Under Investigation (PUI), 462 confirmed Covid-19 cases, 6321 Person Under Monitoring (PUM), and 35 deaths;

WHEREAS, DILG Memorandum Circular No. 2020-063 dated 27 March 2020 entitled “Interim Guidelines on the Management of Human Remains for Patient Under Investigation (PUI) and Confirmed Corona Virus Disease 2019 (Covid-19) Cases” provides a standard process on properly managing human remains of Patient Under Investigation (PUI) and Confirmed Covid-19 Cases;

WHEREAS, the management of the dead is one of the most difficult part of disaster management. As such, there is a need to develop a systematic approach in handling dead bodies from their recovery, identification, transfer and find disposal in consideration of the legal requisites, cultural and religious beliefs and norms which will guarantee the respect, for the dignity of the deceased and the rights of their respective families;

WHEREAS, Section 16 of the Local Government Code of 1991 provides that every local government unit (LGU) shall exercise its powers which are essential for the promotion of the general welfare. Within their respective territorial jurisdiction, every LGU shall ensure support and promote the health and safety of its inhabitants;

NOW, THEREFORE, I, FLORENCIO C. GARAY, City Mayor, Bislig City, Surigao del Sur, by virtue of the power vested in me by the law, do hereby order:

Section 1. ORGANIZATION AND COMPOSITION OF THE MANAGEMENT OF THE DEAD AND MISSING (MDM) PERSON TEAM

There shall be an organized Management of the Dead and Missing (MDM) Person Team from Home Quarantine for Persons Under Investigation (PUI) or Symptomatic Person Who Died Similar with Covid-19 and shall be composed of, but not limited to the following:

Chairperson - City Mayor

Members: CLGOO, LCR, CHO, CSWDO, GSO, Local PNP, Local BFP, City Engineering Officer (CEO), CDRRMO, All Punong Barangays in the City & Representative from a reputable Funeral Parlor

Section 2. FUNCTIONS AND OTHER RESPONSIBILITES

The MDM Person Team shall manage the proper disposition of the human remains and management of the bereaved family.

Other responsibilities and related guidelines/procedures:

  • The Local Chief Executive may add additional members as deemed necessary;

  • The Local Philippine National Police (PNP) shall provide perimeter security;

  • All must wear Personal Protective Equipment (PPE) before handling the human remains;

  • Prior to handling, disinfect the body by misting with the standard decontamination solution or any disinfectant spray;

  • Wrap the body with cloth or robust or leak-proof and shall be zipped or closed tightly with tapes and bandage strips with proper labeling. Attach a bio-hazard tag (SUSPECTED or POSITIVE COVID-19-HANDLE WITH CARE) in the cadaver bag;

  • The outside surface of the cadaver bag should be decontaminated by misting with the standard decontamination solution and allow to dry;

  • Ensure that the human remains is fully sealed in an impermeable cadaver bag before being removed from the isolation room or area and before transfer to the mortuary, to avoid leakage of body fluids;

  • When properly packed, the body can be safely transported to the funeral establishment or crematorium;

  • At no instance shall unzipping the cadaver bag of the body and removal of the body fluids;

  • The city LGU shall provide proper transport. Otherwise, the LGU or the next of kin can secure the services of a funeral establishment which will transport the human remains to the burial site/crematorium. The vehicle shall be disinfected immediately after the human remains have been removed;

  • The household shall be advised to clean and disinfect the room occupied by the deceased immediately after the body was removed; and

  • All linens and fabrics by the deceased shall be properly disposed.

Section 3. PRECAUTION FOR ALL HUMAN REMAINS RETRIEVED

a. Care for Human Remains and Environmental Controls in Mortuary

  • All dead bodies must be identified, documented, and correctly labeled with identity labels bio-hazard tag (SUSPECTED or POSITIVE COVID-19 HANDLE WITH CARE) in the cadaver bag;

  • Dead body which is found soiled with blood or body fluids should be placed in a disposable plastic bag instead of linen;

  • Preferably, dead bodies should be stored in cold chambers maintained at approximately 4°C;

  • The mortuary must be kept clean and properly ventilated at all times. Lighting must be adequate. Surfaces and instruments should be made of materials which could be easily disinfected and maintained;

  • Storage and compartments for dead bodies should be easily accessible for both regular cleaning and maintenance;

  • All used linens should be disposed of;

  • Items classified as clinical waste must be handled and disposed of properly according to the legal requirements;

  • Environmental surfaces, instruments and transport trolleys should be properly decontaminated;

  • All bodies should be brought to the preferred mortuary, funeral establishment or crematorium of those who have the duty to make the funeral and burial arrangement of the deceased.

b. Care for Human Remains and Environmental Controls in Mortuary and funeral workers

  • When handling dead bodies:

    • Avoid direct control with blood or body fluids from the dead body;

    • Observe strict personal hygiene and put on appropriate personal protective equipment (PPE) including gloves, water repellent gown and surgical masks. Use goggles or face shield to protect eyes, if there may be splashes;

    • Make sure any wounds are covered with waterproof bandages or dressings;

    • Do not smoke. Do not touch your face, eyes, mouth or nose);

    • Observe proper removal protocols when removing personal protective equipment after handling the dead body. Then, wash hands with liquid soap immediately;

    • Make sure that supply of disposable gloves, protective equipment, alcohol-based hand rub, and disinfectant such as household bleach is readily available;

    • After use, the disposable items such as gloves and protective clothing should be disposed of in a plastic bag and preferably burned for disposable and properly disinfected for non-disposable, after its use;

    • Linen contaminated with blood or body fluids should be disposed of properly;

    • All surfaces which may be contaminated should be wiped with the standard decontamination solution, leave it for 15-30 minutes, and then rinse with water. Metal surfaces could be wipes with 70% alcohol; and

    • Surfaces visibly contaminated with blood and body fluids should be misted with the standard decontamination solution, leave it for 10 minutes and then rinse with water.

Section 4. REQUIREMENTS FOR BURIAL/CREMATION

  • a.The attending physician, City Health Officer, or Medico-Legal Officer shall:

    • Issue death certificate and state the cause of death of the deceased;

      • For death in referral/health facility, the attending physician shall issue the death certificate;

      • For death while on Community/Home Quarantine, the City Health Officer shall issue the death certificate;

      Report death to the City Local Civil Registrar within 30 days after death for registration.

  • b. NO BURIAL/CREMATION shall take place without a validly issued death certificate.

    Section 5. PROCEDURE FOR BURIAL AND CREMATION

    a. Ensure minimal handling of the body.

    • If the person died outside of a health facility, universal, standard and transmission-based precautions shall be applied by the mortuary or funeral establishment;

    • If the person died inside a health facility, tagging shall be done by the local health officer or attending physician and universal, standard and transmission-based precautions shall be applied;

    b. Hygienic preparation, such as cleaning of the body, tidying of hair, trimming of nails, shaving and embalming of the remains SHALL NOT BE ALLOWED;

    c. Only the adult members of the family of the deceased and other persons whose attendance is absolutely necessary may be permitted to attend the funeral and burial of human remains;

    d. For those that will be buried:

    • Remains shall be placed in a sealed casket;

    • Remains shall not be taken to any place of public assembly. Viewing of the deceased shall not be permitted;

    • Burial permit from the city/municipality where the deceased will be buried shall be secured by the next of kin;
      d

    • No remains shall be buried within the twenty-five (25) meter radius of any residential area;

    • The grave shall be at least one and on half (1.5) meters deep and filled well and firmly;

    • The remains shall be buried in a grave where water table is less than two (2) meters deep from the natural ground surface;

    • No human remains shall be exhumed within five (5) years from the cadaver’s burial unless otherwise (provided by designated representative of DOH) when in his opinion the exhumation of the remains will not endanger the lives of the people; and

    • In every exhumation, the human remains must be done in the presence of the City Health Officer (CHO), disinfected, and placed in a suitable and hermetically sealed container.

    e. For those that will be cremated:

    • A written consent shall be obtained from those who are authorized to arrange the funeral or burial rite of the deceased, which allows the conduct of this procedure;

    • The staff of the funeral establishment or crematorium shall ensure the identity of the cadaver to be cremated. Also, they shall exercise due diligence to ensure that this procedure shall not be abused by those persons who committed a crime against the person of the deceased and aims to conceal it;

    • Cremains shall be reduced to the size of fine sand or ashes and packed in a cremains container before they are turned over to the relatives of the deceased; and

    • Cremains shall be place in an appropriate container.

    f. Public and private cemeteries or, private burial grounds shall be designated for the disposal of human remains/cremains. Where relatives of the deceased so wish, cremains shall be allowed to be brought home only in the prescribed container.

    g. Recommended precaution for relatives when handling human remains

    • All are advised of the following measures for health protection:

      • Viewing in funeral parlors and hygienic preparations are not allowed;

      • Embalming is NOT ALLOWED;

      • Direct contact with the human remains is NOT ALLOWED;

    h. For non-Covid-19 related deaths (excluding PUIs)

    • All non-Covid-19 related deaths shall be attended to, applying the usual processes of the concerned Local Government Unit.

    i. Cost of burial or cremation

    • The cost of burial or cremation of a dead person shall be borne by the nearest kin. If the kin is not financially capable of defraying the expenses or if the deceased had no kin, the cost shall be borne by the city or municipal government.

    j. Prohibitions

    • It shall be unlawful for any person (whether natural or judicial entity) to disclose the personal identity of the deceased who died due to Covid-19 and/or its complications to the general public.

      • However, disclosure of the personal information of the deceased shall be allowed in the following cases;

        • A written consent was secured from the deceased while he/she was still alive or from a preferred legitimate and rightful claimant;

        • For purposes of conducting the contact tracing; or

        • If due to political and/or social status of the deceased, there is a need to disclose his name and health status to the public.

    • It shall be unlawful for any person to take, capture, upload or share a photo or video of the last image of the human remains who died due to Covid-19 and/or its complications in any media or social media platform;

    • It shall be unlawful for any person who shall say or commit an act which aims to blacken or defame the image of those who died due to Covid-19 and/or its complications;

    • No remains, whether claimed or unclaimed shall be permitted to be used for scientific or medical purposes and/or medical studies;

    • No health care facilities and its personnel shall withhold the release and burial of the remains of those who died of Covid-19 and its certificate of death.

    h. In case of a mass casualty incident, the cadavers that cannot be attended to immediately by the undertaker or any staff of the mortuary, shall be stored in a refrigerated facility within the pathology department or the mortuary.

    Section 6. MEETINGS

    The Management of the Dead and Missing (MDM) Person Team shall meet at least once a month or as often as may be necessary to resolve issues and concerns related to the implementation of the MDM as a result of Covid-19 and other disaster-related cases.

    Section 7. FUNDING REQUIREMENTS

    The funding requirements in support to the programs, projects, and activities (PPAs) in the management of the dead and missing person/s as a result of Covid-19 and other disaster-related cases shall come from the Local Disaster Risk Reduction and Management Fund (LDRRMF), 20% Development Fund, and other fund source of the Local Government Unit (LGU).

    Section 8. Repealing Clause.

    All prior issuances inconsistent herewith are deemed modified and superseded accordingly.

    Section 9. EFFECTIVITY

    The Executive Order shall take effect immediately upon signing hereof and shall remain in force unless sooner revoked or amended.