'Our safety is becoming secondary': How funeral homes are grappling with mounting COVID-19 deaths
'It took a pandemic for us to be considered essential services,' funeral director says
When the World Health Organization declared the coronavirus outbreak a pandemic back in early March, Bridget Fetterly had a plan to split the staff at her family-owned funeral home in Montreal into two teams. That way, if one team was required to isolate, the second team could step in and keep the business operating.
But as the death toll from COVID-19 began to rapidly rise, Fetterly realized she couldn't afford to only have half of her staff at Kane & Fetterly funeral home working — she was going to need everyone.
Funeral home workers are on the front lines of this pandemic, and like hospitals and grocery stores, they have had to make significant changes to their usual services. But despite having to go into high-risk zones, ration their personal protective equipment (PPE), and provide support to those who have lost loved ones in this unprecedented time, many funeral directors feel as though the role of their staff in helping manage the outbreak is overlooked.
"We're sort of the people that no one wants to talk about because no one wants to deal with death," said Fetterly.
In fact, some parts of Canada didn't consider them essential until two months ago.
"It took a pandemic for us to be considered essential services although we've always felt that we have been for a long time. It's a little disheartening," Ryan Crean, CEO and funeral director of Kearney Funeral Services in Vancouver, said of the situation in B.C.
"We do put ourselves at risk to help families and make sure that people are looked after."
More than 3,700 people have died from coronavirus in Canada in the past two months. While there are just over 1,500 funeral homes across the country, most of the deaths are concentrated in Ontario, Quebec, and British Columbia, leaving the funeral homes in those provinces to meet the demand of burying the bodies.
"We've been increasingly getting more and more and more calls," said Fetterly, whose work days have extended far past a typical 9 a.m. to 5 p.m. shift.
She's been getting so many calls that she now spends most of her evenings at the office just to get everything done and has had to scrap the two-team contingency plan and have all her staff working.
Now, Fetterly worries that if one staff member becomes infected with the virus, they all might be exposed in the office and will need to stay home to isolate. "Our safety is becoming secondary," she said.
Transfer staff doubly exposed
Most of the deaths in Canada have occurred in hospitals and long-term care homes, which has meant transfer staff from funeral homes are going into high-risk zones.
"We're actually more concerned with the living, to be honest, than the deceased," said Jimmy Cardinal, president of Cardinal Funeral Homes in Toronto.
Given the threat of exposure to the virus in those COVID-19 hotspots, management teams at funeral homes have had to find ways to protect the health of their transfer personnel. Part of that has included a stringent uniform of personal protective equipment.
Transfer staff have also been limited to specific entryways at hospitals or long-term care homes when picking up bodies to reduce their risk of exposure.
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Ontario has made an effort to take further steps. The province's Office of the Chief Coroner has ordered funeral home personnel to hand over their stretchers to staff at hospitals and long-term care facilities and have them bring the dead outside.
"It limits the spread from any of the staff from a funeral home going into a facility," said Cardinal.
The situation is different in other provinces. In B.C., Crean said he's had a few facilities offer his staff this procedure, but it's not the norm.
Merely entering those buildings poses a threat to transfer personnel, and handling the bodies of individuals who tested positive for the coronavirus increases that risk. Given the emerging science on the transmission of the virus after death, funeral directors are taking extra precautions.
"We need to treat this like this is an incredibly infectious airborne pathogen," said Crean. "So, we're just going that extra mile to make sure that our staff are looked after."
In a routine pickup, transfer personnel would typically be required to only wear gloves, unless the body was a confirmed case of tuberculosis (TB), explained Crean. Now, with the coronavirus, he's made sure his staff treat every case as if it was as infectious as TB, which means sending them out in full PPE — including gloves, masks, gowns, face shields and even N95 respirators.
"Some people get a little scared," Crean said.
Based on the science currently available, experts believe the virus could possibly remain in or on the body of someone who has died from it.
"It is still possible that someone who is touching or handling the body of someone who has died of or with COVID-19 can become infected," said Dr. Ilan Schwartz, infectious diseases specialist and assistant professor at the University of Alberta.
For comparison, experts have looked at the SARS outbreak in 2003, where some investigations suggest the virus could remain infectious in bodily fluids (blood, urine, and feces) for 72 to 96 hours.
"This doesn't perfectly mimic what happens in a person, but it gives us some ideas on how stable coronaviruses are in different bodily fluids and may give some information on SARS-CoV-2, the causative agent of COVID-19," said Dr. Jason Kindrachuk, a Canada research chair in emerging viruses at the University of Manitoba in Winnipeg.
As in many industries, funeral businesses are facing obstacles acquiring PPE for their staff, despite efforts to supply the equipment to frontline workers.
"They're giving them or selling them to hospitals and other health-care institutions first, so we've been trying to ration as much as we can," said Cardinal.
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A month before the outbreak, he was already finding it difficult to obtain masks and gowns.
"We've been trying to buy as many as we can from our normal suppliers, but a lot of them obviously don't have a lot of stock available," Cardinal said.
In B.C., Crean says he hasn't faced a shortage yet, thanks to orders made in January and February, but his latest replenishment was diverted to a hospital, and three weeks later, he's still waiting to receive a new shipment.
"We definitely do have trouble getting PPE," he said.
When it comes time for organizing funeral services, most places have capped the number of attendees at 10 in order to comply with physical distancing measures.
Most funeral services typically have many more attendees, Cardinal said, although allowing for 10 people "does give the ability for most immediate family members the opportunity to say goodbye."
Cardinal and Fetterly said they have found many people are choosing to postpone funerals altogether.
"People just can't do what they had hoped to do in the past," said Cardinal.