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transmission. Data gaps exist for rates of infection, hospitalization, or death due to COVID-19 by occupational groups in Canada. The available data from elsewhere does not indicate a disproportionate level of COVID-19 infection or mortality among death care occupations compared to other professions with similar occupational predictors of risk (degree of frequent and close-proximity contact, exposure to disease). These predictors of risks suggest that death care professions should continue to apply all necessary precautions to prevent transmission from occurring. Further monitoring and data gathering on COVID-19 outcomes for high-risk occupations should be conducted to better understand the effectiveness of existing mitigation measures, and to be alert to any changes in outcomes, particularly as emerging variants with the potential for increased transmissibility become more prevalent. This guidance aims to clarify the procedures following a death during the COVID-19 pandemic, whether or not the death was related to COVID-19. The guidance applies to staff of hospitals, nursing homes and hospices, people working in community settings, mortuary workers and funeral directors, among others. This document replaces previous Health Protection Surveillance Centre (HPSC) “Guidance for Funeral Directors”. COVID-19 is likely to remain an issue in Ireland for the foreseeable future. The national vaccination programme should result in less transmission and reduced severity of symptoms but deaths during the infectious stage of the disease are likely to be an ongoing concern. This guidance aims to ensure that care of the deceased person is performed safely and respectfully for all involved. Knowledge and research into the implications of COVID-19 for policy and practice are evolving. While some procedures are different from before, the aim is still to ensure a safe, dignified and compassionate approach to end of life. In producing this guidance, the HSE acknowledges with sorrow all the people who have died or been bereaved during the pandemic, whether or not the deaths were related to COVID19. The guidance aims to support a safe return to some of the familiar practices related to death and bereavement. It is designed to support staff and should be used alongside existing end-of-life care policies. The guidance in this document may change to align with the evolving provisions of “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/. Key principles All deaths related to COVID-19 must be reported to the coroner. Aside from this, standard precautions and practice apply unless the deceased person was considered to be an infection risk for COVID-19 at the time of death. In this case, all infection prevention and control (IPC) precautions in place while the person was alive should continue after the person has died. The period of infectivity is up to 14 days after diagnosis. If a person with a diagnosis of COVID-19 dies after the infectious period, the usual standard end-of-life care procedures apply. 4 The following principles underpin the guidance: · Treat the deceased person with dignity and respect. · Treat bereaved relatives and friends with kindness and compassion. · Minimise infection risks and protect staff and others, such as faith leaders and religious personnel, who care for deceased people. People directly involved in the preparation, handling, transport or treatment of people who have died during the pandemic should follow HPSC guidance on infection control and precaution for healthcare workers. It is available at /. People who are involved in the care of deceased people but who have no direct contact with the body should continue to follow current public health advice. How to use this guidance This document contains technical guidance for staff. Towards the end of the document, section 9 contains a list of resources to support people who are bereaved. Section 10 contains information about support for staff involved in the care of deceased people. Sections 11 and 12 offer information about practical resources that can support quality endof-life care and resources for communicating in end-of-life care. The term “relatives and friends” is used throughout this document to denote people who are important to the deceased person, meaning “those closest to the person in knowledge, care and affection”. They may be family members, friends, emergency contacts and/or designated healthcare representatives. 1. Taking a compassionate approach to caring for deceased people This guidance is mainly technical in nature. When carrying out technical tasks, it is critical that everyone: · treats the deceased person with dignity and respect at all times, always referring to them by name · respects the deceased person’s religious or cultural preferences (see below) · ensures that the care provided fulfils any end-of-life wishes that the deceased person may have made known in an Advance Care Plan or verbally · treats bereaved relatives and friends with compassion · gently guides bereaved relatives and friends towards useful information and sources of support (see section 9) · minimise any disruption to established practices related to death and dying 5 The restrictions and uncertainty resulting from the COVID-19 pandemic can intensify the
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