Home COVID-19 Technical Information

Important Advisories

  • Your local and/or state public health officials may be making recommendations for the care of decedents and/or public gatherings that are more stringent than what the CDC and federal government have recommended. In these cases, you should defer to your state and/or local public health officials.
  • The CDC has advised if you think you have been exposed to COVID-19 and/or develop a fever and symptoms, such as cough or difficulty breathing, call your healthcare provider for medical advice. If you are concerned about a potential exposure, this risk assessment for healthcare personnel (HCP) from the CDC may be useful.

Technical Information

NEW: Letter Verifying Critical Infrastructure Worker Status

On March 19, the Department of Homeland Security (DHS) issued guidance to states naming mortuary workers as “critical infrastructure workers. Many states have adopted the DHS recommendations. One thing this order suggests is that critical infrastructure worker should be exempt from “shelter-in-place” mandates.

Because states are adopting “shelter-in-place” or “safer at home” mandates, NFDA has prepared a Certification of Employment document you can show to authorities verifying your status as a critical infrastructure worker.

This Certification of Employment document should be printed on funeral home letterhead, filled out completely, and signed by an owner or manager of the funeral home.

Updated: July 24, 2020

Introduction

According to the CDC, bodies of those who die of confirmed or suspected COVID-19 can safely be transported and embalmed. 

The CDC guidance for funeral home staff emphasizes

 

The guidance also notes that 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 activities should wear disposable gloves. If splashing of fluids is expected, additional personal protective equipment (PPE) may be required (such as disposable gown, face shield or goggles and facemask).”

See Also: OSHA guidance for COVID19

Watch: Practical Guidance Webinars on Embalming COVID-19 Cases.  

 

The CDC guidance represents the minimum precautions a funeral professional should take while caring for the body of someone who died of confirmed or suspected COVID-19. You should use your best professional judgement to determine whether you should take additional precautions beyond what is recommended by the CDC.

Your local and/or state public health officials may be making recommendations that are more stringent than what the CDC has recommended. In these cases, you should defer to your state and/or local public health officials.

 

Update: COVID-19 & Embalming – CDC Stands By its Recommendations

On April 1, NFDA shared information regarding alternate guidance from the World Health Organization (WHO) on embalming individuals who died of confirmed or suspected COVID-19. NFDA immediately reached out to the CDC to clarify what guidance funeral professionals in the United States should follow. On April 3, NFDA learned the CDC stands by its recommendation that pandemic victims can be safely embalmed so long as the funeral professional follows proper safety protocols. Learn more about what the CDC said.

 

New Legal Form: Directions to Hold Embalmed Remains for Future Funeral Service

 

 

Breaking Down the CDC Guidance

For transfers and embalming, the CDC says, “Funeral home workers should follow their routine infection prevention and control precautions when handling a decedent who died of COVID-19.” 

The CDC’s Emergency Operations Center (EOC) – phone: 770-488-7100 – is available for urgent consultation should you need additional guidance regarding a confirmed or suspected case of COVID-19. 

 

Transfers

If you are conducting a removal from a hospital, nursing home or other healthcare facility, ask about any specific precautions, guidelines or procedures you need to follow beyond what may be outlined below when you arrive. 

Note: If the medical examiner/coroner has not performed his or her examination/investigation and the funeral home is delivering the decedent to their office, do not apply disinfectant or any other chemicals to the remains. Doing so could interfere with the official investigation into the death. See the video “A Special Message from Wally Hooker, CFSP, MBIE” on the Practical Guidance Webinars page

  1. 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.
  2. Follow standard precautions, including donning PPE (e.g., mask, eye protection, gloves, disposable gown).
    1. If you anticipate splashing or aerosolization of fluids, consider additional PPE (e.g., faceshield or goggles and facemask; respiratory protection).
    2. See CDC recommendations about selecting appropriate PPE.
  3. Carefully place body into a body bag, taking care to prevent splashing or aerosolization of fluids, and close it.
    1. On May 4, the CDC issued updated postmortem guidance for selecting body bags. The guidance notes: "Standard body bagging procedures should be followed, consistent with procedures used for deaths where COVID-19 is not suspected. Given the varying weights of decedents and variety, construction, and conditions of body bag materials, postmortem care workers should use prudent judgement determining if risks for puncture, tearing, or failure of body bags could occur and whether a second body bag or a body bag of thicker, stronger material (e.g. minimum of 6 mil thickness) is necessary." Read the full guidance for selecting body bags (see the "Transportation of Human Remains" section on the page). 
  4. Disinfect the outside of the bag with a product with EPA-approved emerging viral pathogens claims.
  5. Doff (take off) your PPE.
  6. 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.
  7. The decedent can be moved out of the facility using nitrile gloves.
  8. After the decedent is placed in the removal vehicle, remove your gloves and dispose of immediately. Wash your hands with soap and water for at least 20 seconds or use hand sanitizer.
  9. Use nitrile gloves to transfer the decedent from the removal vehicle into the funeral home.
  10. After the decedent is in your prep room, remove your gloves and dispose of immediately.
  11. 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.


The CDC guidance represents the minimum precautions a funeral professional should take while caring for the body of someone who died of confirmed or suspected COVID-19. You should use your best professional judgement to determine whether you should take additional precautions beyond what is recommended by the CDC.

 

Embalming

  1. 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.
  2. Follow standard precautions, including donning PPE (mask, gloves, disposable gown).
    1. If you anticipate splashing or aerosolization of fluids, consider additional PPE (e.g., faceshield or goggles and facemask; respiratory protection).
    2. Wear appropriate respiratory protection if any procedures will generate aerosols or if required for chemicals used in accordance with the manufacturer’s label.
    3. Wear heavy-duty gloves over nitrile disposable gloves if there is a risk of cuts, puncture wounds, or other injuries that break the skin.
    4. See CDC recommendations about selecting appropriate PPE.
  3. Prepare and embalm as normal (e.g., washing, setting features, arterial and aspiration/cavity embalming, etc.), taking care to minimize splashing and aerosolization of fluids.
    1. Take steps to safely conduct aerosol-generating procedures; see CDC Postmortem Guidance.
  4. Doff (take off) your PPE.
    1. Fresh PPE should be donned for other preparation and for cleaning the prep room after embalming has taken place.
  5. 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.

For other preparation (e.g., dressing, styling hair, applying cosmetics and casketing), appropriate PPE should be used. See CDC recommendations about selecting appropriate PPE.

The CDC guidance represents the minimum precautions a funeral professional should take while caring for the body of someone who died of confirmed or suspected COVID-19. You should use your best professional judgement to determine whether you should take additional precautions beyond what is recommended by the CDC.

 

Cleaning Your Prep Room After Embalming

  1. 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.
  2. Follow standard precautions, including donning fresh PPE (mask, gloves, disposable gown).
    1. See CDC recommendations about selecting appropriate PPE.
  3. Cleaning should be conducted in accordance with manufacturer’s instructions. Products with EPA-approved emerging viral pathogens claims are expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
  4. Doff (take off) your PPE.
  5. 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.

 

In late-July 2020, the Environmental Protection Agency (EPA) released additional options for COVID-19 disinfectants.

The CDC guidance represents the minimum precautions a funeral professional should take while caring for the body of someone who died of confirmed or suspected COVID-19. You should use your best professional judgement to determine whether you should take additional precautions beyond what is recommended by the CDC.

 

Other Recommendations

  • Embalming experts Wally Hooker and Matt Smith shared recommendations for transfers and embalming for COVID-19 patients; You may view their videos here. Their personal recommendations include guidance that go above and beyond CDC recommendations.


The CDC guidance represents the minimum precautions a funeral professional should take while caring for the body of someone who died of confirmed or suspected COVID-19. You should use your best professional judgement to determine whether you should take additional precautions beyond what is recommended by the CDC.

 

 

Access to PPE

We know the availability of PPE is a critical concern for funeral directors everywhere. Your access to PPE is vital to your ability to continue to safely serve families. NFDA is continually petitioning federal officials – CDC, FEMA, Health and Human Services, the President, Congress, state governors and others – about ensuring funeral home are on the priority list for receiving these critical supplies. We are also exploring private avenues from around the world that can offer PPE to funeral professionals. 

Securing PPE continues to be a top priority for NFDA.

NFDA has learned that PPE in the Strategic National Stockpile and PPE being manufactured now are being sent to FEMA, which will distribute it to each state’s Emergency Operations Center (EOC) based on need. Each state EOC manages requests from entities within its respective state, including deathcare professionals. To place a request for PPE, you’ll need to contact your state’s EOC, which we understand many of you continue to do without reply.

Due to the unprecedented nature of this pandemic, we have observed some shortcomings in communication between local, state and federal agencies and funeral homes making requests for PPE at the local or state level are being met with confusion. NFDA will continue to discuss logistics with our federal partners, and suggest you also contact your state association as they are on the front lines at the state level and have been working in conjunction with NFDA to address issues as they arise.

If you become aware of a solid lead for PPE, please contact NFDA at nfda@nfda.org.

We will continue to provide updates on this essential issue.

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