Relatives of people who died while infected with COVID-19 are calling for the relaxation of strict rules, saying they are causing distress and leaving no dignity to dying patients.

Times of Malta is informed that the health authorities are contemplating revising the rules under which funerals and burials can be held for patients who die when COVID-19 positive.

But until that happens, families and friends of the deceased say they are being rendered helpless and subjected to unnecessary pain.

What are the rules?

With the current rules, the relatives of all those who had COVID-19 at the time of death, are not allowed to visit them in hospital due to fears of infection.

Once a person dies, their family is not allowed to see the body, which has to be buried within 24 hours. And to make matters worse, the grave of a person who died when COVID-positive cannot be opened before 10 years elapse.

This has been resulting in people reluctantly opting to bury loved ones in an area at the Addolorata Cemetery designated for people infected with the virus, instead of burying them in family graves for fear of blocking the grave for a decade.

What do families want?

In a poignant open letter to the health authorities, Antonia Bugeja wrote about the “heartbreak” she and her family went through when her elderly mother died while COVID-positive this month.

Antonia was not allowed to be near her dying mother and, once she passed, the burial was rushed.

“It has been two years going into the third year of this terrible pandemic, and although we usually speak very highly of our health system, unfortunately not much has been done to grant COVID patients dignity and courage to recover at Mater Dei or at least grant patients a peaceful death by allowing at least a visitor behind a glass-covered window, given the circumstances,” she wrote.

Antonia’s words reflected what many others have been going through since the pandemic hit Malta in March 2020.

Last week, Times of Malta reported how the son and daughter of a 77-year-old terminal-cancer patient were upset because his last wish, to be buried near his wife, could not be respected as he was listed as COVID-positive when he had tested negative to a swab test carried out the day before.

The siblings were told that the family grave would not be opened for 10 years following his burial and they feared taking the risk.

After the story was published, several people shared the heartbreak they had to go through because a loved one died when positive with the virus.

So far, more than 500 people have died while COVID-positive. Back in March 2020, COVID victims had to be buried within a few hours of being pronounced dead and funeral masses were not allowed.  Measures were relaxed in October that year, giving relatives of COVID-19 victims 24 hours to bury their deceased family members and allowing funeral masses. Things have not changed since.

According to current regulations, viewing of the body is not permitted and people in mandatory quarantine are not allowed to attend the ceremony.

Relatives are not allowed to see the body, which has to be buried within 24 hours

This has fuelled heartache over the last months when the numbers of infected people rose and those in quarantine spiked.

How do other countries compare?

In the UK, the measures are similar but less rigid than Malta. Viewing the body is not banned so long as the necessary personal protective equipment is worn, and people in quarantine can be exempt to attend a funeral of a close relative while respecting several safety restrictions.

According to the European Centre for Disease Prevention and Control guidelines, “viewing of the body for mourners can be performed and so long as mourners receive support in the appropriate use of PPE. In case of limited PPE availability or shortage of staff to supervise visitors, consider to restrict touching during viewing.”

How do the rules impact the grieving process?

Restrictions on being close to dying loved ones, having a rushed funeral, and conditions on grave-opening have all heightened people’s grief. 

Dr Michael Galea, a clinical psychologist who specialises in bereavement, explained that while grief is a natural process for a loss suffered, “this grief is more painful if the loss comes upon us suddenly, with no warning or any type of preparation”.

“One present reality we are all witnessing is the loss through the COVID-19 pandemic.

“The speed by which these individuals, some of them our own family members, are given the last rites and buried, is another factor that is truly hard to fathom. 

“Thus, our grief and mourning, our bidding farewell, becomes all the more complicated with the pandemic’s situation,” he said.

Grief during the pandemic, he said, becomes more challenging as it comes with an added layer of emotion.

“In whatever you do, be kind to yourself. Beware of certain feelings, such as feeling guilty or angry for not having the time to process the departure of your loved one. 

“What you did not do as a traditional farewell to your loved one, you can always do in your own time, place and ways.”

Open letter: 'I am writing with a broken heart'

Prof. C. Gauci and the Hon. C. Fearne,

I am writing on behalf of my family, with a broken heart, to express the trauma, following the death of my mother, who was a COVID patient and due to the present situation, she was left alone for a week, denied any visitors and ultimately, she passed away alone at Mater Dei Hospital.

It has been two years going into the third year of this terrible pandemic, and although we usually speak very highly of our health system, unfortunately not much has been done to grant COVID patients dignity and courage to recover at Mater Dei or at least grant patients a peaceful death by allowing at least a visitor behind a glass-covered window, given the circumstances.

The last time we saw our mother was on the 3rd of January, when she was admitted with a high temperature and a cough. Little did we know that after she was tested positive, we were never going to see her again. When in hospital we could barely hear her voice over the phone throughout the week as she was all the time with her oxygen mask, and the few short calls we shared were very sad, as she continuously cried and complained that she was very lonely.

My mother passed away a week after she was admitted to hospital on the 9th of January. The news was given to us over the phone, and we were not allowed to even look at her body from behind glass. This was very upsetting as we still question whether it was actually her in the coffin or not. Then there was the issue of the funeral where in less than 24 hours, we had to organise the funeral, which makes it difficult for family and friends to attend on such short notice

To add insult to injury, when we went to retrieve her personal belongings, these were not found and we were told that they were probably thrown away, which was very upsetting following all the ordeal we went through. May I add that considering the circumstances, the staff were exceptionally helpful and understanding.

God help us and many other families who lost their loved ones whilst positive with COVID 19, as this has been a very painful episode which has left us brokenhearted and we only hope that the system will be improved for future COVID patients.

Yours faithfully,

Antonia Bugeja