Provincial guidance to ensure the safety of workers handling COVID-19 suspected or positive decedents.
Last updated: September 11, 2020 at 12:00 PM
This guidance will help to assist people who may handle the bodies of deceased persons during the COVID-19 pandemic. This guidance has been developed to ensure that the deceased are treated with sensitivity, dignity, and respect, and that people who come into contact with the deceased are protected from infection.
The evidence base regarding the risks of COVID-19 transmission from handling the bodies of deceased persons suspected or confirmed to have COVID-19 is in the preliminary stages of development. In the interim, it is appropriate to handle all deceased persons in accordance with the much more robust body of evidence that exists for cases of influenza.
The spread of COVID-19 occurs through droplets that are produced when a person with COVID-19 coughs or sneezes. This route of transmission is less likely to occur when handling human remains or performing post-mortem procedures; however, there may be spread by contact or inhalation, especially if there is a full post-mortem (autopsy) of a body.
Everyone should practice basic precautions to prevent the spread of COVID-19, including maintaining physical distance from others, regular and diligent handwashing, cleaning and disinfecting frequently, avoiding touching your face with unwashed hands, and staying home if sick.
Workers who handle decedents must follow the Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings, which includes the appropriate use of personal protective equipment (PPE), handwashing, and environmental and equipment cleaning and disinfection. Workers should wear disposable gloves, and long-sleeved fluid resistant gowns, and a fluid resistant mask and eye protection if there is a risk for splashes. Post-mortem examinations carry a higher risk for aerosol-generating medical procedures; an N95 (or equivalent) respirator that is fit tested should be worn during examinations.
Workers should apply principles of cultural sensitivity. If loved ones of the deceased wish to view the body, they may do so. If indicated, provide PPE to the family, along with instruction for proper use. Everybody observing the preparation of the body should maintain a 2-meter distance.
In remote and isolated communities, bodies may be kept in the home immediately after death. Left untouched, these bodies are not a transmission risk to others. Where funeral service personnel are not available, community members may move the body, taking care to avoid direct contact as much as possible.
Place the body into a clean, leak-proof 0.4 MIL (or greater) body bag following viewing on the unit, ward, or community setting. Place the body bag on a clean transport gurney.
Remove PPE, perform hand hygiene, and don a new pair of gloves to wipe clean and disinfect the body bag, handles, and any other surfaces. Do not re-dip a cloth into a cleaning solution; use a new cloth each time additional cleaning and disinfecting solution is required.
Follow standard procedures for transporting the body to the funeral home or designated storage location within the facility (e.g., morgue) for pick up by a funeral home or transfer storage. Do not label the body bag as COVID-19 positive or negative.
In health care settings, follow standard operating guidelines and processes for environmental cleaning and disinfection of the patient area, handling of linens, and waste management.
In non-health care settings, advise household members and caregivers to clean and disinfect surfaces in the decedent’s room following the guidance on Cleaning and Disinfecting Public Settings. Laundry can be done with other household laundry; perform hand hygiene after putting laundry in the washing machine.
If an autopsy is required, follow organizational guidelines and practices and the guidance in on this page.
When accessing the body from the body bag, place a non-medical mask or face covering over the nasal and oral cavities to prevent droplet dispersal during movement. Shrouding or bathing of the body for funeral or memorial services should be performed by following the Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Healthcare Settings. Avoid unnecessary manipulation that may expel air from the lungs. Clean and disinfect surfaces and equipment regularly.
Rental caskets should be avoided as it is difficult to disinfect reusable parts of the caskets.
The risk of transmission of the virus through the embalming process is not yet known; however, as the process of embalming involves manipulation of the body and manipulation increases the risk of aerosolization, appropriate PPE, including an N95 or equivalent respirator is strongly recommended.
Mourners who wish to touch the body of a person who died may do so; hand hygiene should be performed afterwards.
A person who has died and is a suspected or known to have COVID-19 can be buried or cremated as usual.