John Hlangeni was the first person known to have died of the Covid-19 coronavirus in the Free State. Refilwe Mekoa spoke to his family and found out more about how the dead church elder’s family was treated in Mangaung
On March 31 the Free State reported its first Covid-19 coronavirus death and South Africa’s third.
The man who died was 85-year-old John Hlangeni, a local church elder.
To his family Hlangeni was more than just a Covid-19 statistic. When Spotlight spoke to his family recently, their grief was still fresh.
Hlangeni’s son, Gopolang Hlangeni, remembered his father as an avid reader who enjoyed telling stories. “He loved spending time with his great-grandchildren and watching wrestling with them on TV. He was a soft man who enjoyed spending his time doing the Lord’s work. My father was a pastor in the Global Reconciliation Church and a respected man in his community.”
The family believed Hlangeni would still be alive if he was tested for the virus and not just screened.
Free State health authorities traced Hlangeni after he attended a church service that resulted in the province’s biggest cluster coronavirus outbreak. The three-day church gathering was held on March 9-11. At least 895 people attended and more than 70 later tested positive for Covid-19.
Spotlight tried to confirm the exact number of people identified, but the Free State department of health did not respond by time of publication.
Gopolang said the results of the initial screening came out negative and his father only became ill later.
“The thing about screening is that it doesn’t mean if you’re not infected today, you won’t be infected tomorrow,” said Shabir Madhi, a professor of vaccinology at Wits University.
Madhi said what we now know about the virus is that most people that are infected won’t even have symptoms. “The purpose of screening in the community is to isolate those individuals, to trace their contacts and put them in quarantine to reduce the rate of transmission. It is impossible to test all 58 million South Africans and you would need to test them every three to four days,” he said.
After Hlangeni died, his family was told to view his remains for the last time before his body was wrapped. They were told the remains needed to be “covered”. Gopolang said his father’s body was kept in the morgue of Pelonomi Academic Hospital in Bloemfontein, where it remained for four days.
Their undertaker was told to fetch the body only on the day of the funeral. Hlangeni died on Monday morning and was buried on Friday that week. Gopalong said for the family there was no need to keep their father’s remains for longer because the funeral could only be attended by close relatives.
Under the Disaster Management Act regulations, only 50 or fewer people may attend a funeral.
Gopalong (60) described the funeral as different from what they are used to in their culture. He told Spotlight that the environmental health officials and the police were present throughout. A register was kept of everyone who came to the family home and those who attended the funeral service. This was done for contact tracing, should the need arise.
“Everyone who came to the house before, during and after the funeral had to write down their names and contact details,” Gopalong explained.
“We were not allowed to see the body at the funeral. There were only close relatives present, and they were fewer than 50 people. The undertaker came with the corpse from the hospital on the day of the funeral and once it arrived at home, the procession immediately went to the graveyard,” Gopalong said.
“A backhoe was used to fill the grave unlike what we’re used to in our culture where men use spades to fill the grave – to ensure social distancing.
“My father’s funeral took about an hour as oppose to the almost six hours we are used to,” said Gopolang.
After the burial, environmental health official disinfected their home. Everyone in the Hlangeni household, including relatives, were tested for Covid-19. Four family members, including his 81-year-old wife, tested positive. They were all isolated at the Pelonomi Hospital, for between 16 and 20 days.
Since Hlangeni’s passing, stricter measures on the handling of Covid-19 victims’ remains have been implemented by municipalities across the country.
The Mangaung Metropolitan Municipality recently issued a statement that all remains of positive people should be considered a “biohazard”. The municipality also called for stricter measures because “Covid-19 remains may cause severe human disease and may also present a high risk of spreading the virus”.
But Madhi didn’ agree with the municipality’s measures, saying there was no scientific basis for such recommendations.
“There’s no other country in the world that is considering a corpse of someone who died of Covid-19 as a biohazard. All that needs to happen is that the same type of precautions that are exercised with any other corpse needs to be adhered to. You need to wear a mask and cover your hands when you’re handling the corpse. This is not Ebola,” he said.
“We won’t get any reports of anyone being infected through the corpses of a Covid-19 victim because of handling the body. It’s highly unlikely.”
Dr Sabeehah Vawda, a virologist from the School of Pathology at the University of the Free State, was less critical of the measures. He said the municipality’s decision was most likely based on advice from experts within the departments of health and environmental health.
Vawda said there was “definitely a need for regulations” on the use and disposal of personal protective equipment and hygiene practices for all individuals handling the bodies of coronavirus victims.
Vawda stressed that it was important to understand that Sars-CoV-2, the virus that causes Covid-19, had only recently been discovered and information about it, its transmissibility and effects was constantly being updated based on new research.
“Since the virus has been shown to survive for prolonged periods on different surfaces, there is a possibility that the corpse may still harbour the infectious virus on the surface, which may pose a small risk of viral transmission to those handling the body,” said Vawda.
But he also acknowledged that according to the World Health Organisation (WHO), there was no evidence of people having become infected from exposure to the bodies of those who succumbed to Covid-19. The department of health has developed Covid-19 Environmental Health guidelines, which provide more details.
The WHO also issued guidelines on Infection Prevention and Control for the Safe Management of a Dead Body in the context of Covid-19. Repeated attempts to get comment from the municipality on this issue were unsuccessful.
Undertakers get Covid-19 training
Meanwhile, as the Covid-19 death toll rises, plans to educate funeral undertakers in Mangaung are underway. The municipality has trained undertakers, as they will eventually deal with the remains of people who died of Covid-19.
The municipality’s guidelines specify that the remains will be kept only in designated mortuaries. Upon death, the remains are moved from the health facility – a hospital or isolation centre – to the designated mortuary. Where necessary, a forensic pathology vehicle will transport the remains.
Meanwhile, on May 3 the Free State health department announced the death of a 51-year-old man, the sixth person to die of Covid-19 in the province. According to the statement, the man had underlying health conditions. He was treated at Pelonomi Netcare Private Hospital where he succumbed to the virus. This raises the number of deaths in the province to six, so far.
By Tuesday the tally for confirmed Covid-19 cases in the province stood at 126 – 112 of them in Mangaung – with 96 recoveries. According to the department, 794 049 people have been screened in the province and 9 152 have been tested.
Health spokesperson Mondli Mvambi says they will intensify screening and testing across the province to ensure they reach out to all the areas.
Never lose hope
Although Gopolang lost his father, he is happy that his mother who was gravely ill, and his relatives, have all fully recovered.
Even though they wish Hlangeni had been tested earlier, Gopolang tells Spotlight that the family is satisfied with how the entire process was handled by the health department and officials from the Mangaung metro.
Gopalong has some encouraging words for others who have lost loved ones to Covid-19: “To those going through the same thing, all I can say is there is hope. Never lose hope. My mother and other family members have proved that people can recover.”
* This article was produced by Spotlight – health journalism in the public interest. Like what you’re reading? Sign up for our newsletter and stay informed.