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Old 03-19-2020, 09:04 AM
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Post CDC COVID-19 - Guidance for Funeral Directors

CDC COVID-19 - Guidance for Funeral Directors
By: (*) The National Funeral Directors, Assoc. - 03-16-20
Re: https://www.nfda.org/covid-19

(*) Capt. Jim M. Shugart - Dr. Sarah Reagan-Steiner - Dr. David Berendes

Note: God forbid you suffer a loss of a loved one. But if so: Note the following rules being sent out to the Funeral Directors.

Topic: CDC COVID-19 Guidance for Funeral Directors - Updated March 18, 2020

Contents:

* Introduction
* Transfers and Embalming
* Funeral Professionals Who are Pregnant or Breastfeeding
* Availability of PPE
* Cremation or Burial
* Visitations and Funerals
* Deaths Overseas and Ship Outs
* Communicating With the Public
* Funeral Home Owners

Introduction:

As you are aware, the situation surrounding the COVID-19 pandemic is fluid and official CDC guidance is continually evolving based on new information from scientists and public health officials.

NFDA continues to lead the conversation with federal officials about the role of funeral service during the COVID-19 pandemic. We are dedicated to sharing accurate, reliable information from trustworthy sources and are doing so as quickly as we can.

While we know you may have questions that are not covered by the information shared below, we are committed to getting answers to you from experts and we ask your patience as we go to bat for you.

On March 11, At the request of NFDA and as a follow up to the postmortem guidance released by the CDC in late-February, the agency released specific information about funeral and visitation services to help funeral directors safely care for people who have died of confirmed or suspected COVID-19.

Specifically, this answers the following questions:

* Am I at risk if I go to a funeral or visitation service for someone who died of COVID-19?

* Am I at risk if I touch someone who died of COVID-19 after they have passed away?

* What do funeral home workers need to know about handling decedents who had COVID-19?

* What should I do if my family member died from COVID-19 while overseas and what are the requirements for returning the body to the U.S.?

In summary:

* While it is possible to have a funeral, they must, in the interim, be limited. Updated guidance released by the White House on March 16 suggests no public gatherings larger than 10 people for the next 15 days. Updated guidance from the CDC released on March 16 suggests no gatherings of more than 50 people for the next eight weeks. Information below offers suggestions for how you may handle services in the interim.

* Bodies can be transferred and embalmed using proper PPE.

* Decedents can be buried or cremated but state and local requirements may vary.

Review the CDC guidance for funerals:

We encourage you to also read this entire page and to share the information immediately with your staff.

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

Transfers and Embalming:

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:

* Transporting bodies in a body bag and disinfecting the bag with a product that contains EPA-approved emerging viral pathogens claims.

* The guidance states: "If it is necessary to transfer a body to a bag, follow Standard Precautions, including additional personal protective equipment (PPE) if splashing of fluids is expected." This guidance also about the use of Standard Precautions, including additonal PPE if splashing is involved also applies to embalming.

* Frequently Asked Questions about Personal Protective Equipment (CDC)

* It is always better to don (put on) more PPE and be safe than sorry. All PPE should be donned (put on) and doffed (taken off) and disposed of properly.

* CDC: Guidance for the Selection and Use of Personal Protective Equipment in Healthcare Settings - this would apply to funeral directors and embalmers.

* Disinfecting contaminated surfaces using products with EPA-approved emerging viral pathogens claims is of utmost importance.
Embalming expert Matt Smith shared a video with his recommendations for transfers and embalming. You may view it here.

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).”

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

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.

Funeral Professionals Who are Pregnant or Breastfeeding:

COVID-19 is a new disease and the CDC is still learning how it spreads, the severity of illness it causes, and to what extent it may spread in the United States. There is limited information about the impact on the virus’ impact on women who are pregnant or breastfeeding.

Pregnant healthcare personnel (HCP) should follow risk assessment and infection control guidelines for HCP exposed to patients with suspected or confirmed COVID-19. Adherence to recommended infection prevention and control practices is an important part of protecting all HCP in healthcare settings. Information on COVID-19 in pregnancy is very limited; facilities may want to consider limiting exposure of pregnant HCP to patients with confirmed or suspected COVID-19, especially during higher risk procedures (e.g., aerosol-generating procedures) if feasible based on staffing availability.

There is an FAQ on the impact of COVID-19 on pregnancy and breastfeeding on the CDC website. (While this FAQ is directed toward healthcare workers, the same advice would apply to funeral home workers.)

NFDA also recommends you follow the advice of your obstetrician.

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

Availability of PPE:

NFDA is aware of the challenges with PPE. We have spent more than a decade building relationships with federal official responsible for responding to public health crises and mass-fatality situations. We are leading a discussion with federal officials about ensuring funeral home staff are on the priority list for receiving these critical supplies.

Already, the White House has issued an Executive Order that would fast-track FDA approval and domestic production of PPE and other pharmaceutical and medical supplies needed by those on the front lines of the COVID-19 pandemic.

During a live NFDA Facebook event with the CDC on March 16, the federal experts recommended that funeral homes that are concerned about a potential or imminent shortage of PPE should contact their state health department or local healthcare coalition as they are best positions to help troubleshoot through potential shortages.

We will continue to provide updates on this essential issue. In the meantime, the CDC has offered some guidance:

Strategies for Optimizing the Supply of N95 Respirators:

* Conventional Capacity Strategies

* Contingency Capacity Strategies

* Crisis/Alternate Strategies

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

Cremation or Burial?

At this time, the CDC states that decedents with COVID-19 may be buried or cremated according to the family’s preferences. However, you should “check for any additional state and local requirements that may dictate the handling and disposition of the remains of individuals who have died of certain infectious diseases.”

NFDA has been made aware of concerns about a recommendation to cremate individuals who die of COVID-19 in the state of Nevada. We are seeking clarification on this.

Please see the information provided by the Department of Veterans Affairs National Cemetery Administration for information about interment in veterans cemeteries.

Check with your state veterans cemetery for information about any operational changes they may be making during the pandemic.

Visitations and Funerals:

At this time, CDC guidance states, “There is currently no known risk associated with being in the same room at a funeral or visitation service with the body of someone who died of COVID-19.” However, the CDC also notes, “People should consider not touching the body of someone who has died of COVID-19.” Therefore, you can make this recommendation to the families you serve.

On March 15, the CDC issued new guidance for mass gatherings recommending that for the next eight weeks (until May 10), organizers cancel or postpone in-person events that consist of 50 people or more throughout the United States.

The CDC suggested during the live Facebook event with the CDC on March 16 that funerals can still take place under the 50-person limit. For funerals taking place, they suggested limiting attendance to select family and livestreaming the service for those who cannot attend; services could also be recorded and the video shared with whomever the family deems appropriate. They further advised that those who are ill and are at-risk (e.g., elderly, immune-compromised) should be encouraged to stay home. Funeral homes should also urge attendees to follow recommended healthy habits such as social distancing, hand hygiene, covering cough and sneezes, etc.

In a breaking update, the afternoon of March 16, the White House released “The President’s Coronavirus Guidelines for America - 15 Days to Slow the Spread.” Among these guidelines are that people “Avoid social gatherings in groups of more than 10 people” for the next 15 days (until March 31).

It would appear this would impact funerals/viewings in that they would be limited – perhaps to immediate family only – for the next 15 days. Funeral directors could offer livestreaming as an option for these services/viewings and, perhaps, recommend the family hold a larger memorial gathering at a later date. Services could also be recorded and the video shared with whomever the family deems appropriate. After this 15-day period concludes, the restrictions would continue with the CDC's eight week limitations on mass gatherings.

A note about webcasting:

The initial information NFDA had about the funeral home webcasting license it offers covering ASCAP, BMI and SESAC seemed to indicate that livestreaming funeral services containing copyrighted music was only permitted through the websites of the funeral homes holding a webcasting license.

However, on March 18, NFDA was able to confirm that NFDA webcasting license does allow performance of ASCAP, BMI and SESAC copyrighted music on Facebook and YouTube as would occur during funeral services.

If you do not currently have a NFDA funeral webcasting license, click here for more information and to purchase one.

Please note: In some cases, Facebook or YouTube may take videos down or stop a live stream because they are unaware the funeral home has the appropriate webcasting license and is permitted to stream funeral services with copyrighted music.

If you hold a webcasting license and find your streams or videos are being blocked or taken down, please take a photo or capture a screenshot of the notification you receive stating your videos or live feeds are being blocked/taken down. Send this photo or screen shot to NFDA (nfda@nfda.org) and the issue will be directly addressed with Facebook and/or YouTube.

NFDA General Counsel Scott Gilligan is reaching out to Facebook and YouTube to proactively address this issue of blocking or removing streams and videos. We ask funeral homes’ patience as we work as swiftly as we can to put this issue to rest.

NFDA is also working to update the webcast license receipt to include language stating that the license permits performances of copyrighted music licensed by ASCAP, BMI and SESAC on Facebook and YouTube.

* List of Webcasting Businesses - Note: NFDA does not endorse these companies. This list is simply being provided for the convenience of funeral professionals.

NFDA offers sample legal forms that give authorization for funeral homes to webcast funeral services and direction to record funeral services.

Ultimately, funeral homes have to determine how they will best balance the important guidance they are receiving from federal, state and local public health officials with the needs of their families.

As with any gathering or event, you should check with local health officials to determine whether there are any prohibitions on holding public events, such as a visitation or funeral. Some states or cities have begun restricting public gatherings; these restrictions take precedence.

As an extra layer of precaution for those you serve, as well as you and your staff, you may want to consider:

* Encourage people who are ill or who are part of an at-risk population (e.g., the elderly, immune-compromised, etc.) to stay home.

* Reminding families how to prevent the spread of COVID-19, such as by staying home if you are sick, social distancing, washing your hands, and covering coughs and sneezes.

* The CDC has great informational flyers about healthy habits, such as “How to Stop The Spread of Germs,” you can post in your funeral home.

* Keep soap dispensers filled in public (and employee) restrooms. The CDC has several informational flyers on handwashing you can post in public and staff restrooms.

* Offer alcohol-based hand sanitizer that contains at least 60% alcohol to guests (and employees).

* Have extra tissues on hand:

As a business open to the public, it’s important that you and your staff be vigilant about cleaning, especially after services or arrangement conferences. The CDC offers guidance for businesses – including recommendations on cleaning products – on cleaning facilities open to the public.

Some funeral homes are taking additional measures such as:

* Scaling back direct contact with families and guests (e.g., handshakes, hugs, etc.)

* Keeping the front door open (weather permitting) or ensuring a staff person is always available to open a door during visitations and services to prevent people from touching the door knob

* Offering free or reduced cost webcasting

You know your business operations best and, with your staff, can develop a plan to action to help families commemorate the life of their loved ones in a safe manner that is consistent with federal, state and local guidance.

Deaths Overseas and Ship Outs

Deaths Overseas:

The CDC guidance for funeral directors states:

When a U.S. citizen dies outside the United States, the deceased person’s next of kin or legal representative should notify U.S. consular officials at the Department of State. Consular personnel are available 24 hours a day, 7 days a week, to provide assistance to U.S. citizens for overseas emergencies. If a family member, domestic partner, or legal representative is in a different country from the deceased person, he or she should call the Department of State’s Office of Overseas Citizens Services in Washington, D.C., from 8 am to 5 pm Eastern time, Monday through Friday, at 888-407-4747 (toll-free) or 202-501-4444. For emergency assistance after working hours or on weekends and holidays, call the Department of State switchboard at 202-647-4000 and ask to speak with the Overseas Citizens Services duty officer. In addition, the U.S. Embassy closest to or in the country where the U.S. citizen died can provide assistance.

CDC does not require an autopsy before the remains of a person who died overseas are returned to the United States. Depending on the circumstances surrounding the death, some countries may require an autopsy. Sources of support to the family include the local consulate or embassy, travel insurance provider, tour operator, faith-based and aid organizations, and the deceased’s employer. There likely will need to be an official identification of the body and official documents issued by the consular office.

CDC requirements for importing human remains depend upon if the body has been embalmed, cremated, or if the person died from a quarantinable communicable disease.

At this time, COVID-19 is a quarantinable communicable disease in the United States and the remains must meet the standards for importation found in 42 Code of Federal Regulations Part 71.55 and may be cleared, released, and authorized for entry into the United States only under the following conditions:

* The remains are cremated; OR

* The remains are properly embalmed and placed in a hermetically sealed casket; OR

* The remains are accompanied by a permit issued by the CDC Director. The CDC permit (if applicable) must accompany the human remains at all times during shipment.

* Permits for the importation of the remains of a person known or suspected to have died from a quarantinable communicable disease may be obtained through the CDC Division of Global Migration and Quarantine by calling the CDC Emergency Operations Center at 770-488-7100 or emailing dgmqpolicyoffice@cdc.gov.

Please see CDC’s guidance for additional information.

Ship Outs:

Funeral directors should consult with the U.S. embassy of the country that will be receiving the remains for any country-specific shipping requirements and documentation. NFDA also advises consulting with the airline that will be carrying the body to determine if it has any specific requirements. You can find embassy and airline contact information on the NFDA website.

Communicating with the Public:

If you wish to share information with your community discussing funerals for confirmed/suspected cases of COVID-19 and the steps you are taking to keep families, guests and others safe, NFDA has prepared a news release template – download it here. You can customize this news release with specific information about your funeral home and the steps it is taking during this unprecedented time. The text in this news release can also be adapted for use as a message on your funeral home’s website or social media platforms.

NFDA will be developing other tools to help you communicate with the public about funeral service during the COVID-19 pandemic.

The CDC has excellent flyers/posters you can post in your funeral home about COVID-19 and healthy habits they should follow during the pandemic.

Funeral Home Owners:

As a funeral home owner, it is your responsibility to protect the health and safety of your staff. We urge you to carefully review this funeral home-specific guidance as well as:

* CDC Resources for Businesses and Employers.

* Information from OSHA about employer obligations during the COVID-19 situation: Guidance on Preparing Workplaces for COVID-19 and OSHA’s COVID-19 Information Page.

* An FAQ on COVID-19 prepared by SESCO Management Consultants, NFDA’s endorsed human resources consultants.

* The Department of Labor’s information regarding COVID-19-related issues.

* Also review guidance from your state's department of labor for guidance related to your locality.

We encourage you to prepare a plan of action for your business and then meet with all full- and part-time staff – from funeral directors to administrative assistants to maintenance staff – to ensure everyone is aware of the role they can plan in keeping themselves, their co-workers and client families safe. As new information comes up, share it with all staff.

In addition to discussing your plan of action with staff, also be in communication with other third-parties you may work with such as florists, caterers, removal services, etc.

Note: NFDA cares deeply about the health and safety of you and those you serve. We pledge to do all we can to keep everyone informed of the latest information. Watch this page, your email and NFDA’s social media accounts for updates as they become available.
__________________
Boats

O Almighty Lord God, who neither slumberest nor sleepest; Protect and assist, we beseech thee, all those who at home or abroad, by land, by sea, or in the air, are serving this country, that they, being armed with thy defence, may be preserved evermore in all perils; and being filled with wisdom and girded with strength, may do their duty to thy honour and glory; through Jesus Christ our Lord. Amen.

"IN GOD WE TRUST"
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Old 03-19-2020, 09:21 AM
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Boats Boats is offline
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Post Italy's military deployed to transport bodies of those killed by coronavirus outbreak

Italy's military deployed to transport bodies of those killed by coronavirus outbreak
By: Danielle Wallace - Fox News - 03-13-20
Re: https://www.foxnews.com/world/italy-...mated-funerals

The northern Italian city of Bergamo, which is the nation’s worst-hit by the coronavirus, received help from the military Thursday to transport bodies to nearby towns to be cremated.

A convoy of at least 10 military trucks arrived in Bergamo, which sits northeast of Milan in the Lombardy region, to pick up coffins from the city crematorium and several morgues overwhelmed by the recent spike of deaths, national newspaper Corriere Della Sera reported.

ITALY'S CORONAVIRUS DEATH TOLL NEARS CHINA'S AFTER LARGEST ONE-DAY SPIKE DESPITE LOCKDOWN

The mayor of Bergamo, Giorgio Gori, received help from 12 neighboring northern Italian towns to cremate 67 of the dead. He promised their ashes would later return to Bergamo, the local newspaper L'Ecio Di Bergamo reported. Even operating around the clock, Bergamo’s crematorium could only cremate 25 bodies a day, a spokesman said, according to Sky News.

Bergamo is the most heavily hit town in Italy by the coronavirus outbreak, recording at least 93 deaths and at least 4,305 cases in the city as of Wednesday.

About 60 percent of Bergamo’s roughly 120,000 residents could be infected by the novel virus, Mirco Nacoti, an anesthesiologist and intensive-care specialist, estimated to the Wall Street Journal on Tuesday.

In all of Italy, at least 2,978 people have died and at least 35,713 people were infected, according to figures provided by Johns Hopkins University last updated 11:33 a.m. GMT (7:33 a.m. ET). Italy has a population of about 60 million people.

A video posted by Italian journalist David Carretta on Monday compared obituary lists in two issues of the local newspaper L'Ecio Di Bergamo. The obituary section spanned 10 pages in a copy dated March 13, compared to only about a page and quarter in an earlier edition dated February 9, which fell the outbreak in Italy became widespread.

Italy saw its largest spike in deaths within a 24-hour period Wednesday since the country recorded its first confirmed case, according to the health ministry. It is the most heavily hit nation in the world outside of China, where the virus originated in late December.

Funeral services have been suspended in Italy amid a nationwide lockdown that began March 7. A video posted by the Italian newspaper Il Messaggero showed coffins lined up in one Bergamo church. Coffins were also seen stacked at three morgues, two belonging to a hospital and one to a cemetery in Bergamo, as burials are backlogged, Business Insider reported.

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Personal note: This virus is deadly. Sean's like this are happening all around the world.
I still don't know what causes these types of deadly virus's suddenly appearing? But we may someday find out and hopefully before we run out of populations around the globe.

I'm not a doomsayer but these issues when they happen it turns the world order into a panic. Is it just Mother Nature or is it an environmental issue or just a mutated bug gone wild. Last I heard it may be a bat in someplace in China? But no one really knows for sure - yet!

Boats
__________________
Boats

O Almighty Lord God, who neither slumberest nor sleepest; Protect and assist, we beseech thee, all those who at home or abroad, by land, by sea, or in the air, are serving this country, that they, being armed with thy defence, may be preserved evermore in all perils; and being filled with wisdom and girded with strength, may do their duty to thy honour and glory; through Jesus Christ our Lord. Amen.

"IN GOD WE TRUST"
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