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Sent from pillar to post after losing a loved one to COVID-19
On January 12, Premadasa from Kadawatha died at the Ragama Teaching Hospital. The 75-year-old had succumbed to complications arising from COVID-19, his death certificate said. But he never figured on the Government’s public lists of those who had perished from the virus.
This case highlights just some of the difficulties families and overworked authorities face when people die of COVID-19.
Premadasa complained of vertigo on December 31 last year. A nearby doctor took his pressure and prescribed medicine while his blood reports were found to be clear. Wasantha, his son, wanted to be identified by one name and requested the same for his father.
The final moments of a COVID-19 victim. Pix by Rahul Samantha Hettiarachchi
On January 4, Premadasa and his wife contracted fever. Wasantha consulted another doctor in Kadawatha who sent them home with medication. Whilst his wife’s fever subsided in a day, Premadasa had a temperature and lacked appetite. He was advised to take a full blood count and urine report.
Wasantha escorted him to the Kiribathgoda Base Hospital. After questions on his symptoms, two doctors sent them home with instructions to administer Paracetamol every six hours and fluids.
To be safe, they took a full blood count and urine test on the way. A doctor examined the reports the next morning and said there could be a bacterial infection and also a “kidney problem” that can be addressed later. An antibiotic was prescribed.
Two days later, Premadasa lost appetite again. Wasantha returned with him to the Kiribathgoda hospital where his temperature was checked (he no longer had fever) and a doctor examined his case. He was admitted, given saline and three blood samples taken.
Wasantha returned home. It was still morning and he wanted to be back at noon with pillows, sheets and food. But he received a call saying Premadasa was transferred to Ragama. His father seemed fine during evening visiting hours. He had even eaten a hospital meal. The ward said he didn’t need a personal attendant.
Wasantha was happy. As he was leaving, Premadasa told him to tell his mother she can take off her mask (she had kept on since the day her husband fell ill) and that he’s coming home soon. The following afternoon, however, Wasantha found his father on the hospital bed, covered head-to-toe in a sheet.
“I thought he was sleeping,” he narrated. “I tapped him and told him that I had brought his lunch.” It was another patient that revealed Premadasa had died around 7.30 that morning. “Nobody had called me,” Wasantha said. “And even at 1pm, the body was on the bed.”
Everything then became more complicated. The ward first handed him a form to certify his father had no valuables on him. Next, he was directed to the hospital police who instructed him to go with his 80-year-old mother–who didn’t yet know of her husband’s passing–and his father’s identity card to the Kadawatha police before returning to the registrar’s office at the hospital for a death certificate.
Wasantha insisted that his mother was too old and would be distraught to make that trip. As he had no siblings, the police finally agreed that he could take just his father’s ID. The Kadawatha police immediately scolded him for not having come in earlier. They got the message at 7.30am, they berated. But what was Wasantha to do when nobody had told him?
It was now close to 3pm on January 12. The policeman assigned to the case said he was off at 4pm and that “nothing was likely to happen today”. He shared his telephone number with Wasantha and sent him back to the registrar’s office in hospital where he was appraised that Premadasa’s file was returned to the ward to rectify a mistake.
Wasantha had no clue where his father’s body was. But he did know it had been subjected to a PCR test. And the hospital told him that, should the results be positive, the police would come to his house “at whatever time in the night”. So he should go home.
“If the police don’t come what should I do?” he asked (as this would mean the PCR test was negative). “If your mother can’t manage it, bring your wife and return to the registrar’s office because we need two people from the family to be present,” was the reply.
None of the details were clear. Wasantha didn’t even have time to process his father’s death. In confusion, he telephoned the policeman at Kadawatha who was handling his case. He told Wasantha to return to the hospital the next morning as he would be there with another set of cases.
Wasantha and his wife stood near the registrar’s office but the police didn’t arrive. They still didn’t know what his father’s PCR test outcome was. So, he hesitantly walked to the nearby inquiries desk and asked. The file was summoned and checked. The result was positive.
“We were pointed back to the registrar’s office and asked to stand much further than before,” Wasantha narrated. “But however long we waited, nothing happened. It was around three hours and our legs were hurting. We were also quite anxious now because my father’s result was positive and we didn’t know what would become of us, including my two young children and aged mother.”
The policeman handling Wasantha’s case finally arrived at the registrar’s office. He claimed that, since this was a COVID-19 positive death, the procedures would be completed at the ward and not at the registrar’s office.
So, Wasantha and his wife went back to the ward and conveyed messages through passers-by asking someone to meet them. “Nobody came,” he said. “We waited there for one hour, sending message after message. Finally, a doctor told us that the ward won’t give us a death certificate. We were back at the registrar’s office where they took my telephone number and released us.”
With no feedback for several hours, it was Wasantha that called back. “My father lived in our house,” he pleaded. “We are scared. We are being sent all around just to settle my father’s death certificate and deal with the body. Tell us what to do.”
They told him to buy a coffin from a named undertaker and that the cremation will take place at the Batuwatta cemetery. “The cheapest coffin was Rs 25,000 and the crematorium would cost Rs 7,000,” Wasantha said. “On top of the grief, the time-wasting and multiple procedures, the fear and anxiety, we now had to find money. There are families in far worse situations than us.”
The undertaker claimed the coffin was expensive because “there was risk involved and others don’t want to do this business”.
Since Wasantha wasn’t sure whether he was infected, he had asked a cousin to come with him to the funeral parlour. “We stood outside while he made inquiries,” he said. “Obviously, they asked for the death certificate. The hospital still hadn’t given us one. The body couldn’t be released from the mortuary. And we couldn’t apply for a cremation.”
Exhausted, Wasantha and his wife came home in a three-wheeler. He notified the hospital that they could do nothing without a death certificate.
By then, Public Health Inspectors (PHIs) had pasted a notice saying their house was under quarantine. But Wasantha received yet another call summoning him to the hospital with his father reports and the medication he had taken leading up to his death. “I told them we were under quarantine,” he said.
Meanwhile, the area PHI instructed Wasantha to bring his family to Delgoda for PCR tests. “I told him we were under quarantine, and there were five of us but just one motorbike,” he said. “They sent a small jeep for us. There were more than 200 people waiting to be tested at the Delgoda public playground and 80 ahead of us in the queue. Just one person using the same pair of gloves and personal protection equipment took swabs.”
The police had dropped in while they were away, a neighbour said. “When I telephoned, they told me my father’s cremation had taken place,” he recalled. “I was taken aback. I asked them how that could have happened without anybody notifying me.”
The policeman checked again. He said the cremation hadn’t taken place. Wasantha was drowning in confusion. From the day his father passed away, he and his cousin had taken call after call, just to get a death certificate and complete final rites. But even the policeman now said he wasn’t sure what the problem was.
Wasantha eventually understood that ward doctor wasn’t releasing the cause of death so the registrar could not issue the certificate. “The judicial medical officer called me and said they were applying for a court order for an inquest,” he related. “I had thought till then that COVID-19 positive bodies were disposed of within 24 hours. Anyway, I was never shown the court order.” Two close relatives are required to be present at an inquest. This did not happen either.
Even five days after Premadasa’s demise, there was no funeral. Wasantha’s cousin went from pillar to post, taking leave from his job. “At one point, he was so frustrated, he snapped at the authorities that they could do whatever they wanted with the body,” he said.
Wasantha’s cousin did eventually get the death certificate. The cause of death was given as heart attack precipitated by COVID-19.
“While they claim COVID-19 positive bodies are cremated immediately, I believe there are many instances when they are not,” Wasantha said. “And the trouble we went through after losing our father was terrible.”
Authorities said the case was complicated as Premadasa’s PCR report returned positive after he died in hospital within 24 hours of admission. The ward doctor decided to call for an inquest and the coroner said it couldn’t be done, requiring the Judicial Medical Officer to obtain a court order.
“There needs to be a regular mechanism because such delays worsen the suffering for relatives,” one doctor said. “And medical authorities are also under so much pressure. We are handling multiple issues and the calls, the complaints, the grief, all come to us.”
Based on the mixed messages Wasantha received, it was clear hospital authorities had also struggled with protocol—not granting the death certificate, requesting possible COVID-19 positive relatives to be physically present, sending them from pillar to post for a week before the body was released. The family still doesn’t know whether an inquest and a full or partial post-mortem were done.
Wasantha’s cousin was present at the cremation but did not see the body. It could’ve been anyone he says. The workers at the crematorium also demanded Rs 5,000 for completing the task and refused to issue a receipt.
On the day of the funeral–January 18, seven days after the death–the PCR reports of Wasantha’s wife and two children came back positive. While he and his mother had spent the most time with Premadasa, their tests were negative.
Till now, Premadasa has not been included in the daily list of COVID-related deaths released by the Government.