Care of the Deceased During Pandemic FAQ
Answers to questions posed at the May, 2006 pandemic plan preview meetings.
Posted: 7/12/06
What has the state done to plan for mass casualties during a pandemic? Have these plans included resources out state; i.e. crematories, mass storage of bodies, what about religious and cultural issues on disposal of the dead?
The state has applied for and received federal funding to hire one full time person who's responsibility is to plan for "care of the deceased" during a pandemic influenza. Planning will include all of these issues.
Who is responsible for payment of the site and final disposition?
At this time, this question has not been answered. Both the local government and the state will probably be involved. There may be federal money to help offset some of the costs involved. We just do not know at this time.
Can the county take state land under imminent domain law?
This is highly unlikely. If a city or a county has to implement a temporary cemetery site, the key word is "temporary." We do not intend to bury bodies and have that be their "final resting place." Once mortuary services are able to recover from the surge of deaths that have overwhelmed their local resources, the bodies would be disinterred and returned to the funeral home of the family's choice for burial or cremation.
Who would the funeral directors report to?
Funeral homes don't really need to "report" to anyone. They will go about their business in a usual manner and once they are unable to keep pace with the surge of deaths in their area, the state plan for assistance (temporary morgue/processing center) would kick in. The state will work with funeral homes and local governments to help them in their planning.
If a relative lives on a farm and wants to bury their family members on the farm site, can they do this?
Technically, yes. However, the process for designating a piece of private property as "private cemetery" is burdensome and costly. State law requires all dead human bodies to be buried in a dedicated cemetery or be cremated. So, without having the family farm site legally turned into a cemetery, it would be unlawful to bury family members there.
If they can’t, what authority is there for law enforcement to take possession of the body?
The District Attorney could probably "take possession" of a body if they felt it was necessary. However, that would probably be the last of their concerns during a crisis like pandemic.
If someone wants to bury their family members on the farm site, they should start the process of doing it correctly and hire an attorney and have them read and follow Minnesota Statutes 306 and 307.
How will the Mortuary providers handle such an influx in bodies?
Mortuaries, hospitals, nursing homes and other care facilities in some areas of the state will be overwhelmed by a surge in death tolls should pandemic influenza strike. In those areas, planning will be required so that an effective response is coordinated. The Mortuary Science Section within the Minnesota Department of Health has been assigned this task.
What is a temporary morgue?
A temporary morgue is a location that will be used to process dead human bodies when mortuaries have been overwhelmed in certain geographic areas of the state. Once local mortuaries are able to return to normal business operations, they would come to the temporary morgue on behalf of the family contracting with them for the funeral arrangements.
If someone dies as a result of pandemic influenza, is the body still infectious?
Influenza is spread by inhalation of respiratory aerosols, by deposition
of respiratory aerosols on the mucous membranes of the eyes, nose, or
mouth, and by inoculation of the eyes, nose or mouth by hands contaminated
with respiratory secretions. Once an infected person dies they
will no longer be expelling aerosols, however the airspace of a recently
deceased patient may contain respiratory aerosols for a short period
of time after death and the respiratory secretions of the patient could
also be infectious for a period of time after death.
Therefore, the following recommendations are for family members of the
deceased:
Respiratory protection should continue to be worn by family members in the airspace of the patient immediately after the patient's death. Contact with the respiratory secretions of the deceased should be avoided. If the family of the deceased patient wishes to touch the body, they may do so. If the patient died in the infectious period, the family should wear gloves and gowns and follow with hand hygiene (washing hands with soap and water or using an alcohol-based hand rub). If family members want to kiss the body (hands, face) these body parts should be disinfected, using a common antiseptic (e.g., 70% alcohol). If the family wants to view the body and the face of the deceased, but not touch it, there is no need to wear gowns or gloves.
If my family member dies in our home, is there anything I need to do to preserve the body until someone (funeral home, etc.) is able to collect it?
The WHO (World Health Organization) recommends that the bodies of persons who have died from pandemic influenza be wrapped in a plastic sheet or plastic body bag for transport. Prior to removal from the home, family members could cover the body with a sheet or a blanket. Other than that, the best thing that could be hoped for is to keep the body in a cool place. The state will be working on a way to notify authorities of deaths that take place in homes when local mortuaries are no longer able to conduct business as usual.
Will cremation be mandatory during a pandemic?
No.
Will families be able to hold traditional funeral services during a pandemic?
Probably not. More than likely, public gatherings will not be allowed, and that would include funerals. Private family funerals will be allowed and everything possible will be done to allow for normal, religious and cultural ceremonies.
With so many deaths, how will people be able to keep track of deceased family members?
The state is working on a web-based computerized system that will address this issue.
How will death certificates be handled?
Most death certificates are already done electronically by funeral homes and doctors/M.E.'s /Coroners. Once funeral homes are overwhelmed by a surge in deaths, the temporary morgues would take over and process the death certificates. Copies of the certificates are available at local county offices.
Will bodies be collected and disposed of in mass graves?
If temporary morgues are required in certain areas of the state, bodies would be collected in non-traditional methods. For instance, the National Guard may be used to collect the dead. If the surge is so great that refrigeration of the dead is not possible, then "temporary" burial may be required. Again, religious and cultural issues will be a factor in this decision. There may be no need for temporary burial if a pandemic strikes during the winter. If that is the case, natural refrigeration would be possible until mortuaries are able to recover and return to normal business.
Is there any planning going on to address the psychological impact on families who may have witnessed the death of (a) loved one(s)?
At this time, the Mortuary Science Section within the Minnesota Department of Health has only considered the impact on the death care industry workers. There may be other state agencies that are working on this.
Is MDH planning statewide with morticians?
Yes. Summer meetings with morticians representing all regions of the state are planned for July/August. Informational meetings reaching 100% of funeral homes are planned for September/October.
Who will be trained for the care of the deceased?
Funeral homes, medical examiners/coroners, health care facilities, National Guard, state and local governments.
What if the next of kin doesn’t want their relatives buried at the site; what authority is there on this issue?
Every accommodation will be made to honor the cultural and religious customs of individuals. However, if temporary burial is necessary, family wishes can be honored during the recovery stage of a pandemic.
Will funeral homes be embalming bodies?
As long as funeral homes have the time to do embalming, they may do so.
Mass burial sites: a. who has the authority to pick a location; b. who will pay for this?
Local government.
Is the state really planning to stock all mortuary supplies? i.e. body bags, embalming fluids?
No. The state will stock supplies to provide resources in areas of the state where mortuary services have been overwhelmed.
What type of planning efforts have been done or should be done at the local level for medical examiners, coroners, funeral homes, etc?
Talks have already begun with the medical examiner/coroner association to address issues specific to a pandemic influenza.
In the overall death count 3,600-32,900 is the lack of ventilators added into the overall death count? Or do the numbers increase in overall death count?
Using the projections and assumptions from HHS, we calculate that there would be an extra 3,600 (moderate pandemic) to 32,900 (severe pandemic) deaths in Minnesota over an 8 week period, in addition to the normal death rate. According to these same projections, between 1,120 and 12,900 people would need ventilators.
