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Guidance for Funeral Homes re COVID-19
May 26, 2020

 

Recommended Guidance1 for Preventing Spread of COVID-19 in Funeral Homes

1 Source: Community Mitigation Controls

I. Background

SARS-CoV-2 is a novel coronavirus that has emerged and caused coronavirus disease (abbreviated as COVID-19). Public health experts continue to learn about SARS-CoV-2, but based on current data and similar coronaviruses, spread from person-to-person happens most frequently among close contacts (those within about six feet) via respiratory droplets. Transmission of SAR-CoV-2 to persons from surfaces contaminated with the virus has not been documented yet, but current evidence suggests that SARS-CoV-2 may remain viable for hours to days on surfaces made from a variety of material. One primary measure discussed in this guidance will be cleaning of visibly dirty surfaces followed by disinfection – a best practice for prevention of COVID-19 and other viral respiratory illnesses in funeral homes and other locations.

II. Purpose

This guidance provides recommendations for funeral homes in Illinois.

III. Preventative Actions for Funeral Homes Directors

A funeral or visitation service can be held for a person who has died of COVID-19 with certain restrictions. Persons who have COVID-19 or are exhibiting symptoms of COVID-19 should be restricted from attending the funeral service or visitation to prevent its spread to others who are attending. Try to provide ways for family members or close friends to join the service remotely through use of available technology or offer to record the funeral service for later viewing.

Consistent with the recommendations from the Illinois Funeral Directors Association (IFDA) Board of Directors, Funeral Home Directors should follow the CDC guidelines on gatherings, including those directly related to any funerals, visitations, or graveside services. All gatherings of ten (10) or more should be canceled, and/or only conducted with a limit of ten (10) or less people. Viewings should only be conducted on bodies that have been embalmed and should only be permissive with ten (10) or less people. Graveside services should be private and conducted with ten (10) or less people. This information is subject to change per recommendations by the Federal Government and CDC.

Decedents with COVID-19 can be buried or cremated but check for any additional state or local requirements that may dictate the handling and disposition of the remains of individuals who have died of certain infectious diseases.

IV. Preventative Actions for General Public Attending a Funeral Service or Visitation

COVID-19 is a new disease and we are still learning how it spreads. The following basic precautions should be followed by everyone in the general public:

• stay home if you are sick;

• follow proper hand hygiene protocols: o wash hands often with soap and water for at least 20 seconds;

  • use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water is not available;
  • soap and water or a 60% alcohol-based hand sanitizer should be used if the hands are visibly soiled;

• avoid touching eyes, nose, or mouth with unwashed hands;

• avoid close contact with people who are sick.

Following social distancing recommendations and proper handwashing will help prevent the spread of the disease. The virus that causes COVID-19 is thought to mainly spread from close contact (i.e., within about 6 feet) with a person who is currently sick with COVID-19 as well as contact with surfaces contaminated with the SARS-CoV-2 virus. The virus likely spreads primarily through respiratory droplets produced when an infected person coughs or sneezes, similar to how influenza and other respiratory infections spread. This type of spread is not a concern after death. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. People should consider not touching the body of someone who has died of COVID-19. Older people and people of all ages with severe underlying health conditions are at higher risk of developing serious COVID-19 illness. There may be less of a chance of the virus spreading from certain types of touching, such as holding the hand or hugging after the body has been prepared for viewing. Other activities, such as kissing, washing, and shrouding should be avoided before, during, and after the body has been prepared, if possible. If washing the body or shrouding are important religious or cultural practices, families are encouraged to work with their community cultural and religious leaders and funeral home staff on how to reduce their exposure as much as possible.

At a minimum, people conducting these higher risk activities should wear disposable gloves. If splashing of fluids is expected, additional personal protective equipment (PPE) may be required (such as disposable gown, faceshield or goggles and facemask).

 

V. Preventative Actions for Funeral Home Workers Handling Decedents

Funeral home workers may potentially be exposed to the COVID-19 virus if they are entering homes or other locations where persons with COVID-19 are present, and they may not know if a person has died from COVID-19 or if other persons at the same location have COVID-19. Unless the funeral home worker knows that they will not be exposed to COVID-19 when they are going to a location to handle a decedent, it is recommended that they follow Standard Precautions, and use PPE that has been recommended for Emergency Medical Service employees.

Funeral home workers should follow their routine infection prevention and control precautions when handling a decedent who died of COVID-19. If it is necessary to transfer a body to a bag, follow Standard Precautions, including additional PPE if splashing of fluids is expected. For transporting a body after the body has been bagged, disinfect the outside of the bag with a product on the EPA’s List N: Disinfectants for Use Against SARS-CoV-2. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.). Wear disposable nitrile gloves when handling the body bag. Body bags and removal pouches should be properly disposed after they are used, unless manufacturer’s instructions allow for reuse after proper cleaning and disinfection.

Embalming can be conducted. During embalming, follow Standard Precautions including the use of additional PPE if splashing is expected (e.g. disposable gown, faceshield or goggles and facemask). Wear appropriate respiratory protection if any procedures will generate aerosols or if required for chemicals used in accordance with the manufacturer’s label. Wear heavy-duty gloves over nitrile disposable gloves if there is a risk of cuts, puncture wounds, or other injuries that break the skin. Additional information on how to safely conduct aerosol-generating procedures is in the CDC’s Postmortem Guidance.

Cleaning should be conducted in accordance with manufacturer’s instructions. Use EPA-approved disinfectants on the List N: Disinfectants for Use Against SARS-CoV-2, or with a human coronavirus claim. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).

After cleaning and removal of PPE, perform hand hygiene by washing hands with soap and water for at least 20 seconds or using an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water is not available. Soap and water should be used if the hands are visibly soiled. 

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