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transmission through contact with fomites can depend on the concentration of virus and its viability on a specific surface. SARS-CoV-2 has been shown to persist longer on hard smooth surfaces such as stainless steel (several days), and less on porous substances such as cardboard (24 hours) (van Doremalen et al., 2020). Where a person has died from an infectious virus, risk of transmission to others may depend on the viability of the virus in the body, on the surface of the body, or on fomites that may be contaminated with droplets or bodily fluids from the deceased and the potential for others to come into contact with fomites, bodily fluids, or the body itself. Microorganisms associated with the natural putrefaction process that begins shortly after death are nonpathogenic and although some pathogenic microorganisms may be present in the body, most of these do not survive more than 48 hours after death. There is therefore typically a greater likelihood of infection due to improper handling soon after death when pathogens are more likely to remain viable (Cardoso & Vieira, 2016). There is currently uncertainty on how long SARS-CoV-2 persists on human skin or within a body after death, but the potential to remain viable on some surfaces for several days suggests that risks of transmission could remain after death. The primary route of transmission through respiratory droplets is reduced due to absence of coughing or breathing (Hoffman & Healing, 2018) but manipulation of the body during handling or transfers can cause fluids or air in the respiratory tract to be expelled. It is unknown whether, or for how long, viable virus could remain in the body, but as a precautionary measure it could be assumed that viable virus is potentially present. More research is needed to understand how long the virus may remain viable on or within the body after death. To date there have been no confirmed cases of transmission of COVID-19 from a deceased patient however in April 2020, an initial report of presumed infection of a forensic examiner from a deceased COVID-19 patient was reported in Thailand. This report was later revised to clarify that transmission from the corpse to the examiner was a possibility only, and the pathway was not confirmed (Sriwijitalai & Wiwanitkit, 2020). The risk of transmission of SARS-CoV-2 from deceased bodies could exist where viable virus remains on contaminated surfaces or where there is accidental contact with respiratory droplets or bodily fluids of infected bodies through handling or manipulation of the body. The following section examines the possible risks that could arise during the death care process. The International Committee of the Red Cross (ICRC) (Finegan et al., 2020) has designated certain activities that result in contact with the deceased during the COVID-19 pandemic as low, medium, or high risk: Low risk: Activities that result in contact with contaminated surfaces during admission of the deceased to the funeral home, preparation of the body for viewing, and release of the deceased for burial or cremation. Medium risk: Activities that could result in expulsion of droplets from the deceased during rolling, undressing, or significant manual handling of the body, or other low risk procedures that may result in droplets being generated. High risk: Activities that could result in direct contact with bodily fluids of the deceased including the potential for exposure to aerosols. This can include autopsy or other invasive procedures, or medium-risk procedures that are likely to generate aerosols. This could include embalming if the process results in generation of aerosols. Other activities such as attendance of family members or loved ones during the preparation of the body, viewing of the body, or interactions during funeral services can give rise to risks associated with community transmission amongst the living. Table 1 summarizes the key risks that could arise at different stages of the death care process and persons who may be affected. Most agencies agree on the key principles to prevent transmission of infectious diseases, such as COVID-19, during the death care process. These include appropriate training, infection prevention and control (IPAC) protocols, adherence to good hand hygiene practices, the appropriate use of personal protective equipment (PPE) for a given task, and cleaning and disinfection procedures (Ferreira et al., 2018; Fineschi et al., 2020; Hoffman & Healing, 2018). A review of guidance and recommendations on precautions for minimizing transmission of SARS-CoV-2 in death care activities across multiple agencies found agreement for most. A summary of the precautions reported in relation to the risks identified The public health risks associated with transmission of disease during a pandemic require careful consideration and call for thorough preparation and planning for adequate supplies, personnel, and space to avert shortages. When standard precautions for working with deceased known to be infected by a RG3/HG3 pathogen are in place, the risk to mortuary workers is slight (Hanley et al., 2020). However, while death care professionals will be trained in the management of infectious disease including RG3/HG3 pathogens, a pandemic that results in mass fatalities can bring about shortages in essential supplies such as PPE, body bags, cleaning and disinfectant materials,
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