The Malaysian Insight

THE high number of daily Covid-19 deaths is taxing the capacity of the health authorities’ forensic department.

Forensic expert Dr Ahmad Hafizam Hasmi told The Malaysian Insight there is a shortage of autopsy equipment to process the deaths.

Only Kuala Lumpur Hospital (HKL) has a fully equipped chamber room with tools to conduct autopsies on high-risk coronavirus cases, said Hafizam, who works at the hospital’s National Institute of Forensic Medicine (IPFN).

HKL is one of three public hospitals in the country equipped with level 3 biosecurity laboratory facilities (BSL-3) with special ventilation systems.

Hafizam said it is a risky job performing an autopsy on a body with a highly contagious virus such as Covid-19.

He said a trained team must do the job with Level 3 personal protective equipment (PPE).

He added that specialised tools such as computed tomography screening, or CT scan, is mandatory for autopsies on Covid-19 bodies, and this includes cases of patients who are dead on arrival.

“And even if the test shows the body is positive for Covid-19, if there are other injuries, the body will be examined and undergo high-risk autopsy,” he said.

“Without BSL-3, it is difficult to conduct post-mortem examinations as well as ensure security guarantees to staff and the environment in handling high-risk cases.”

He said Level 3 PPE is equipped with a special respiratory assistance system to prevent exposure to the environment in a BSL-3 autopsy room, which has a special ventilation system in an airtight space as well as negative pressure.

Air in the room is removed through an exhaust system equipped with filters and ultraviolet light to kill germs.

“This is to ensure that the air released from this room is free of pathogens, especially Sars-Cov which causes Covid-19,” he said.

Hafizam said these equipment are needed to reduce the risk of spreading the virus outside of the room.

Apart from HKL, only two other hospitals are thus equipped: Sultanah Bahiyah Hospital in Alor Star, Kedah and Queen Elizabeth Hospital in Kota Kinabalu, Sabah.

Every state must be equipped

Hafizam said every state must be equipped with such facilities for epidemic situations.

“If the BSL-3 room cannot be built in every forensic department, the alternative is to build a mobile BSL-3.

“This takes away the need for the body to be moved from one facility to another and the risk of spreading the virus around. The journey also takes time and the body will decay during that time.

Additionally, he said a portable BSL-3 can be moved to where it is needed during an epidemic.

Hafizam said the HKL facility serves several states on the peninsula and is the only facility equipped with autopsy CT scanner capabilities.

“This facility has been available in HKL since 2009 and it is already 12 years old.

“This facility should be available in every forensic department of the state’s major hospitals,” he said.

He said autopsy CT scanner equipment is necessary to guide forensic physicians in managing a death case.

It provides an advantage because it does not require internal examination, and offers security assurance to staff as well as speeds up the examination and management of corpses.

“The CT scanner facility is very helpful in determining whether (DOA) cases died due to Covid-19.”

IPFN has a staff of 60 including forensic physicians, medical officers, forensic scientists, nurses and administrative staff.

Malaysia recorded 107 Covid deaths yesterday, for total of 5,108 people dead from the virus. – June 30, 2021.