Quality Assurance Through Standard Operating Procedures Development and Deviation: A Medicolegal Death Investigation Systems Response to the COVID-19 Pandemic.

ABSTRACT: Standard operating procedures drive everyday practice within any organization, including those within a forensic setting. In the event of unusual circumstances, organizations must respond rapidly to address the impact on operations while ensuring that the quality and safety outcomes of routine services are not affected. This case study illustrates how standard operating procedures can be newly developed or modified, and rapidly deployed and quickly revised, to address unusual circumstances. The response to the COVID-19 pandemic is used as an example in this case report.

Interim recommendations for the management of forensic investigation during the COVID-19 pandemic: An Italian perspective.

The Coronavirus disease 2019 (COVID-19) is spreading around the world, representing a global pandemic. In this context, governments from around the world suspended almost all education, industry and business activities, alongside restricting the movement of people. Nevertheless, during this period, the activity of the law enforcement and forensic investigators never stopped. At present, guidelines regarding forensic autopsies of SARS-CoV-2 virus-positive cases and the handling of potentially infected biological samples are available in literature. However, less attention has been given to the development of specific adjustments to the existing crime scene investigation protocols and procedures for this exceptional time. This manuscript aims to share the methods and strategies adopted for the investigation of high priority criminal cases during the pandemic. Furthermore, other pandemic-related processes are critically explored, in order to propose adjustments for any forensic services to be prepared to face similar challenges in the future. The overall goal of this manuscript is to provide a summary of the main measures and the procedures developed to make the operations possible, while safeguarding the technicians in the field and the activity in the forensic laboratory. In order to minimize the risk of infection for personnel, adjustments to the standard practice have been proposed for each of the different phases of crime scene management, i.e. CSI call policy, equipment preparation, working groups, procedure at the scene, chain of custody and analyses of the evidence at the forensic lab. As this is a current study, based on limited cases and limited sources in the literature, changes and updates to the indications provided in this paper may be needed in the near future, according to new virological data epidemiological trends.

Management of the dead during COVID-19 outbreak in Malaysia.

The emergence of a novel human coronavirus, SARS-CoV-2, causing severe respiratory tract infections in humans, is affecting all countries of the world and has become a global health concern. Since the virus was first identified in December 2019, the number of deaths have been propagating exponentially, causing countries across the world, including Malaysia, to increase emergency measures to combat the virus. Due to the fact that the COVID-19 pandemic does not discriminate its victims, it is of paramount importance to construct a plan for management of the dead for all suspected or confirmed COVID-19 cases, including the unidentified deceased, as an essential portion of the humanitarian forensic action approach. This document provides an overview on ways to maximize the local collective capacity from various government agencies to manage the dead based on the prevailing regulations and legislation in the country, in preparation for possible large scale deaths from this pandemic. The National Institute of Forensic Medicine Malaysia has improvised procedures and guidelines for management of the dead within the existing regulations in order to achieve a balance between medicolegal requirements and the safety of personnel managing the bodies of the deceased with suspected or confirmed COVID-19 infection; at the site of death, during transport, during postmortem procedures, storage and preparation before and during burial or cremation as well as environmental cleaning and disinfection, involving various agencies in the country. A form of temporary controlled burial is as an option to allow the reinvestigation of a decedent to help formally identify victims of the pandemic such as undocumented migrants or refugees who were previously not identified. Due to the different legal requirements and mortality rates between countries, there is no one-size-fits-all approach to the management of the dead. Whenever possible, every opportunity and assistance must be given to families to mourn their loved ones, even in times of crisis or an outbreak, in order to sustain an appropriate level of dignity and respect.