New Orleans establishes an official death care task force

As the infection and death rates across Louisiana continue to grow the Mayor of New Orleans LaToya Cantrell wants to create a high level of safety around the dealing of the COVID-19 deceased and as such has set up a death care task force.

The New Orleans death care task force includes funeral home directors, coroners, cemetery directors, hospital officials, faith-based leaders and other stakeholders. The force is responsible for ensuring the proper care of those who passed from COVID-19, based on the newly released Louisiana guidelines.

Louisiana will follow the CDC Guidance regarding the safe handling of COVID-19 positive remains. As well as encouraging funeral arrangements to be held within 3 – 5 days of passing, with only immediate family in attendance.

“The COVID-19 outbreak has created a tragedy within a tragedy: Compromising the way our residents prepare their deceased loved ones to be laid to rest, and share in their grief the way we’re accustomed to. And it won’t get any easier,” Mayor Cantrell said in a statement.

Task force member Dr. Gerry Cvitanovitch, the Jefferson Parish coroner, said that on Sunday he had to rent a refrigerated truck to relieve hospitals of body storage because some funeral home directors and drivers didn’t have proper personal protection equipment until very recently, and therefore couldn’t handle the remains.

He also mentioned that some directors were still reluctant to handle coronavirus victims, although directors of some of the larger funeral homes in New Orleans reported having enough equipment, storage and capacity to keep providing services to families, at least for now.

New Orleans coronavirus guidelines

Guidance for Safe Handling of Human Remains of COVID-19 Positive Patients in Louisiana Region 1 Hospitals

These recommendations give guidance on the safe handling of human remains that may contain COVID-19 and are for use by personnel who perform postmortem care in Louisiana Region 1 hospitals. In patients who die from COVID-19 virus, virus may be transmitted during postmortem care.

Only personnel trained in handling infected human remains and wearing appropriate PPE, should touch or move any COVID-19 infected remains. Handling of the remains should be kept to a minimum.

Personal protective equipment for postmortem care personnel

Personal protective equipment (PPE): Prior to contact with the body, postmortem care personnel must wear PPE consisting of impervious gown with full sleeve coverage, eye protection (e.g., face shield and goggles), N95 facemask, and double surgical gloves. Additional PPE may be required per facility guidelines. Donning and doffing PPE should be done in accordance with CDC Guidelines.

Putting on, wearing, removing and disposing of protective equipment: PPE should be in place BEFORE contact with the body, worn during the process of collection and placement in body bags, and should be removed immediately after and discarded as regulated medical waste. Use caution when removing PPE to avoid contaminating the wearer. Hand hygiene (washing your hands thoroughly with soap and water or an alcohol based hand rub) should be performed immediately following the removal of PPE. If hands are visibly soiled, use soap and water.

Postmortem preparation

Preparation of the body:

Identify (tag) the remains per hospital policy.
Insert cotton balls, wet with antiseptic solution, or other appropriate antiseptic materials into the mouth, nose, and ear openings.
Cover face with antiseptic cloth or other materials, wet with antiseptic solution.
Place the deceased in a white plastic body bag/pouch without contaminating the outside of the body bag/pouch.
Wipe the closed plastic white body bag/pouch, containing the deceased, with antiseptic cloth.
After the white body bag/pouch has dried, place identification of the deceased (Nam, Date of Death, etc.) and indicate that antiseptic packaging has been carried out.
Deceased are to be placed in a white body bag first and then placed into a black body bag second.
Wipe the plastic black body bag/pouch with antiseptic cloth.
After the black body bag/pouch has dried, clearly identify the deceased and indicate that antiseptic packaging has been carried out.
Place a notification tape across the zipper portion of the outer to indicate infectious remains are in the black body bag/pouch.
Transport the bagged deceased to the hospital morgue.
Perform surface decontamination of the transport gurney.
Clean and disinfect the patient’s room according to CDC protocol.
Notify the Coroner’s Office and funeral home that the deceased is COVID-19 positive. Coroner must be notified of all infectious and communicable deaths.
All medical equipment, including but not limited to lines, pics, and tubes be removed prior to sending the deceased to the morgue for release.

NOTE: Because organizations have decreased access to all of facilities, it is recommended to have releases of human remains take place at the point of digress/exit (hospitals, coroners, facilities etc.) instead of having outside personnel enter the facility to make the removal.

Funeral Home Guidance

Funeral Home Staff

PERSONAL PROTECTIVE EQUIPMENT FOR POSTMORTEM CARE PERSONNEL

REMOVAL FROM LOCATION OF DEATH OR LOCATION OF DECEASED

If Hospital, Coroner or Facility Removal – Funeral Home Removal Personnel will inspect for Completion of Facility Preparation as listed above and confirm identity of deceased.

If field death released from place of death – Funeral Home Personnel will perform steps 1-11 and transport to funeral home to prepare for burial.

FUNERAL GUIDANCE

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. A funeral or visitation service can be held for a person who has died of COVID-19 as long as strict adherence to local and state orders are held.

While there is no risk, consideration should be given to the guidance that we should limit community spread by discouraging gatherings.