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diagnosis. If a person with a diagnosis of COVID-19 dies after the infectious period, standard procedures apply. There are, however, specific Government regulations concerning the management of funerals during the pandemic (see section 8.4). The maximum number of people allowed to attend funerals and various premises, including funeral homes, is detailed in “Resilience and Recovery 2020-2021: Plan for Living with COVID-19”. It is available at https://www.gov.ie/en/publication/c4876-covid-19-resilience-and-recovery-2021-the-pathahead/. 13 8.1 Collecting the deceased person’s body Standard operating procedures apply if the person’s death was not related to COVID-19 or if they died outside the infectious stage of COVID-19 (see page 5). If the person died during the infectious stage of COVID-19 (see page 5): · If the person has already been placed in a body bag (inner lining), follow standard procedures. · If the person has not yet been placed in a body bag, wear appropriate PPE (gloves, gown and FFP2 or surgical mask, eye protection) when handling the person’s body. · There is unlikely to be any significant contamination of the removal vehicle as the deceased person will be inside a body bag and, in most cases, a coffin. Clean the removal vehicle in the usual way after the person’s body has been removed. 8.2 Preparing the deceased person for burial or cremation 8.2.1 Embalming HSE advice does not prevent the embalming of a person who died with a confirmed or suspected diagnosis of COVID-19, if it is performed with all necessary safety precautions in place. There may, however, be other reasons why embalming is not advisable or desired. Previous guidance for funeral directors did not recommend the practice of embalming. However, evidence has accumulated and there have been no confirmed reports of SARSCoV-2 transmission from a dead body to a living host, including among persons with high levels of exposure, such as autopsy personnel1 (see section 2). Standard operating procedures for embalming apply if the person’s death was not related to COVID-19 or they died outside the infectious stage of COVID-19 (see page 5). The Health and Safety Authority of Ireland (HSA) has classified SARS-CoV-2, the virus that causes COVID-19, as a risk group 3 biological agent.2 Since guidance on embalming varies internationally, practitioners should undertake appropriate risk assessment to evaluate and formalise their decision to provide this service. Funeral directors should consult the HSA’s Guidelines and Code of Practice in order to risk assess their own facilities concerning the recommended minimum safety practices required for embalming. Embalming is not considered by the HSA to be a laboratory or industrial processes and as such, embalming 1 O’Keeffe, J. Field inquiry: COVID-19 risks from handling the deceased. Vancouver, BC: National Collaborating Centre for Environmental Health. 2021 Feb. agents_introduction/classification_of_biological be employed in line with standard safety measures and risk assessment / mitigation actions. In assessing embalming services, it may also be helpful to refer to the HPSC’s “Guidelines for the Management of Deceased Individuals Harbouring Infectious Disease” which set out practice and facility / premise related guidance including those for embalmers. It may be that, after assessing risk, some providers may decide not to provide embalming services. Referring to this document may help Funeral Directors to explain the reasons for their decision to the deceased person’s relatives and friends. 8.2.2 Medical implant devices Remove implantable cardiac devices before cremation. If the person died during the infectious stage of COVID-19 (see page 5), wear a long-sleeved gown, gloves, a FFP2 or surgical face mask and eye protection. In all other cases, follow standard procedures. 8.2.3 Washing and dressing the deceased person Standard operating procedures apply if the person’s death was not related to COVID-19 or if they died outside the infectious stages of COVID-19 (see page 5). If the person died during the infectious stage of COVID-19 (see page 5): · While preparing the deceased person’s body in accordance with their wishes, religious and cultural preferences, wear a long-sleeved gown, gloves, a FFP2 or surgical face mask and eye protection. · Put a cloth or facemask over the person’s mouth to prevent the dispersal of droplets from their respiratory tract. · When turning and moving a deceased person, put minimal pressure on the abdomen and chest to prevent expulsion of air or other substances from the nose, mouth or elsewhere. · Bathing is the best way of washing the deceased person. If running water is essential, follow standard practice and keep the water pressure low to avoid splashing. · Follow standard practice when dressing the deceased person in their chosen clothes. · Follow standard practice when removing PPE. Wash your hands afterwards. 8.2.4 Placing the person in a coffin Standard operating procedures apply if the person’s death was not related to COVID-19 or if they died outside the infectious stage of COVID-19 (see page 5). If the person died during the infectious stage of COVID-19 (see page 5): · The body bag may be used as the inner lining for a coffin (see section 8.1). 15 · Once the deceased person is in a closed coffin, PPE is not
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