Forensic pathologist reveals what an autopsy shows about Covid

A consultant in charge of carrying out autopsies on Covid-19 patients reveals the horrific toll the virus takes on victims.

Dying of Covid is like drowning in your own body fluid and the terminal fight for oxygen can happen to people as young as 20, a forensic pathologist in charge of carrying out autopsies has revealed.

Dr Heinrich Bouwer a consultant at the Victorian Institute of Forensic Medicine has carried out multiple autopsies on people who died of Covid-19 and reveals for the first time what it’s like to examine the bodies of the virus’ victims.

“It’s quite a dramatic death, basically you are drowning in your own fluids in your lungs.” Dr said.

“The lungs are heavy, congested, full of blood. So the virus actually affects the lining of the alveoli, and the lining of small vessels, causing them to leak fluid into the air spaces,” he said.

The reason the patients die is Adult Respiratory Distress Syndrome — a condition in which fluid collects in the air sacs of the lungs, depriving the organs of oxygen.

A CT scan of normal lungs (left), compared to the lungs of a person who died of Covid (right). Picture: Supplied

The virus has another shocking mechanism that causes severe damage to other major organs in the body.

Tiny micro blood clots caused by the virus can result in severe damage to patient’s major organs, starving them of oxygen and preventing them from working.

“In severe cases, you will have multi system, multi organ failure. The kidneys will shut down, the heart will shut down, the liver will shut down, and cause basically a septic shock picture,” Dr Bower said.

Mortuary instruments at the Victorian Institute of Forensic Medicine. Picture: Supplied

He said the damage Covid caused to the bodies of young people aged in their 20s was what stunned him most about the Delta outbreak.

“We’re getting young people, you know we have cases in their 20s … who died unexpectedly at home, which we didn’t see last year in the first outbreak,” he said.

Most of the autopsies Dr Bouwer has conducted have been on the bodies of people who died in their own homes, as those who die in hospital will have their cause of death certified by a hospital doctor.

However, deaths that are unexpected, not natural, accidental, homicides, suicides, or where there is no clear cause of death have to be reported to the coroner and an autopsy performed, he said.

“Where someone died unexpectedly at home, it’s one of those categories where the case will then be reported to the coroner and they may or may not undergo autopsy.

“We’ve had certainly cases where people refuse to get tested or vaccinated, despite having symptoms and having symptoms for many days and they’re not seeking medical attention until it’s too late,” he said.

Victorian Institute of Forensic Medicine at night . Picture: supplied

He explained the extreme protection measures used when doing autopsies on Covid patients and said although it had not yet been needed, there were contingency plans to use the refrigerators in funeral parlours if Covid outbreaks cause an overflow in morgues.

“Our mortuary is set up to have a special autopsy suite, which is called the infectious room, which hasn’t separate air supply and air sucked out so there’s a negative pressure inside the room so everything that’s vaporised, or droplets that form gets sucked and processed by the airconditioning system,” he said.

Pathologists carrying out the autopsies on Covid patients also have to wear full Personal Protective Equipment (PPE) including glasses or goggles, N95 masks to prevent them from exposure to the virus.

“We do it for cases where people have diseases. HIV is another example where we would use that autopsy suitend we also use the room for decomposed individuals, just because of sanitation, because it has its own air supply. Its basically used on a daily basis,” he said.

The main mortuary at Victorian Institute of Forensic Medicine Picture: supplied

The service has contingency plans in place so it is ready to deal with any unexpected surge in deaths that might overwhelm the morgue.

“We are very fortunate up till now we haven’t had to activate our emergency processes, but we can use hospital mortuaries, private funeral home fridges, etc,” he said.

“We are always ready … we had the Black Saturday bushfires (in) 2009, when that was sort of getting put into place. But we’re always prepared for disasters and mass fatalities,” he said.

Having seen the shocking deaths experienced by those he has examined, Dr Bouwer has one message for Australians: “Get vaccinated.”

“We see young people die at home even though we’ve got very good medical care,” he said.

“We do need to get vaccinated, it’s our only real protection against the spreading disease, getting infected or spreading their loved ones,” he said.