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NJSFDA COVID-19 Guidelines

The Forum - Features
March  2020​

Embalming & Preparation, Contagious Disease Cases, Funeral Director, Mortuaries (Funeral Homes), OSHA Coronavirus, COVID-19

The federal Occupation Safety and Health Administration has classified mortuary and morgue workers as high risk and extremely high risk in a new guidance document for workplaces concerned with exposure to the coronavirus, also known as COVID-19.

With the number of suspected cases growing in New Jersey and nationwide, the guidance provides strong common-sense precautions that those in the funeral industry should take in order to minimize the exposure for both staff and customers.

As previously reported in The FORUM, The U.S. Centers for Disease Control and Prevention had released guidelines for the handling of human remains that may have been exposed to COVID-19.

Those initial measures in the CDC document align with OSHA’s best practices in the preparation room, such as universal precautions, appropriate personal protective equipment, limiting exposure to drainage and aspirate, reducing the number of staff having contact with the remains and the thorough disinfection of all surfaces.

Now, new OSHA guidelines, contained in a 35-page document released on March 9, 2020, are enhanced and include a breakdown of threat levels for various workplaces.

“Very High Exposure Risk” jobs are those with high potential for exposure to known or suspected sources of COVID-19 during specific medical, postmortem, or laboratory procedures. Workers in this category include morgue workers performing autopsies, which generally involve aerosol-generating procedures, on the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death. Aspiration is considered an aerosol-generating procedure.

“High Exposure Risk” jobs are those with high potential for exposure to known or suspected sources of COVID-19. Workers in this category include mortuary workers involved in preparing (for burial or cremation) the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death.

Those guidelines, augmented by the New Jersey State Funeral Directors Association, are as follows.

Employers

Many of the duties at funeral homes prevent staff from simply working from home. Encouraging proactive measures to keep staff well, then being flexible and understanding when people are ill, is key to keeping the community safe during any potential outbreak.

By now, everyone knows the top publicized guidelines regarding personal safety:

  • Wash hands often
  • Avoid touching eyes, nose, and mouth
  • Cough and sneeze into your elbow or a disposable tissue and discard it
  • Maintain distance around sick people.

In the event that a staff member becomes ill, encourage them to stay home. This is a difficult decision to make because the funeral industry relies on staff being present to serve families. With the flu and COVID-19, sick employees need to stay home to recuperate, but also to prevent any further spread of disease.

If this outbreak intensifies, funeral homes may encounter employee shortages from illness, school closures and their caring for family members.

Employers should remember that, during an outbreak, workplaces could experience absenteeism, a change in patterns of commerce and interrupted supply and delivery.

Above all, however, employers should urge everyone to observe this maxim: Keep calm and wash your hands.

Administrative Controls

Workers who need to use personal protective equipment should be retrained in how to put the devices on, how to use and wear them, how to take them off correctly and how to dispose of them.

Safe Work and Funeral Gathering Practices

Don’t forget that viewings, services and funerals could temporarily present their own considerations. The CDC also has developed special guidelines for “Mass Gatherings or Large Community Events” to help you plan and host services should this outbreak worsen.

Funeral directors should provide the following in their workplaces:

  • Tissues
  • No-touch trash cans
  • Hand soap
  • Alcohol-based hand rubs containing at least 60 percent alcohol
  • Disinfectants
  • Disposable towels

The Preparation Room

Funeral directors should continue to follow existing OSHA standards, which are designed to minimize exposure to pathogens. Remember, you may have already embalmed and/or handled a decedent with undiagnosed COVID-19.

Make sure to disinfect your preparation room, instruments, tables, floors, countertops and stretchers more regularly.

In addition, those working in the preparation room should make sure to use proper PPE including: gloves, goggles or face shields, face masks, shoe covers, full body covering and respiratory protection, when appropriate. Remember that the use of respirators requires medical clearance and fit testing.

Make sure the room is properly ventilated and utilize engineering controls. Physical barriers, such as clear plastic covers over drain sinks and drainage areas, should be installed.

Also, the NJSFDA recommends that aspiration only be performed when absolutely necessary.

Respirators

Funeral directors should remember that typically those in funeral service do not utilize appropriate respirators to deal with COVID-19. Our respirators typically are used for formaldehyde. Appropriate respirators are:

  • Disposable N95 filtering face-piece respirators
  • R/P95
  • N/R/P99
  • N/R/P100 filtering face-piece respirators
  • An air-purifying elastomeric (e.g., half-face or full-face) respirator with appropriate filters or cartridges
  • Powered air purifying respirator (PAPR) with high-efficiency particulate arrestance (HEPA) filter
  • Supplied air respirator (SAR)

The Deceased

For any staff who handle decedents who have died from or may have been exposed to COVID-19, useful resources for embalmers, interns and removal staff can be taken from the autopsy guidelines issued by the CDC, entitled “Interim Guidance for Collection and Submission of Postmortem Specimens from Deceased Persons.”

While the guidelines are specifically meant for health care professionals performing autopsies, many of the suggestions are adaptable for funeral directors in the handling of human remains.

The Symptoms

The symptoms of COVID-19 typically include:

  • Fever
  • Cough
  • Shortness of breath

In some asymptomatic cases, those infected have experienced no symptoms at all. Symptoms may appear between two days and 14 days after exposure. The virus is thought to spread mainly from person to person through respiratory droplets.

It may be possible that a person can get COVID-19 by touching a surface or object that has SARS-CoV-2 on it and then touching their own mouth, nose, or possibly their eyes. This is not thought to be the primary way the virus spreads.

A Final Word

The OSHA guidance indicates that, whether there is a significant outbreak of COVID-19 or not, employers should take the threat seriously and be prepared.

“Employers who have not prepared for pandemic events should prepare themselves and their workers as far in advance as possible of potentially worsening outbreak conditions,” the OSHA guidance states.

For more information on precautions you should take in response to COVID-19, attend the New Jersey Funeral Service Education's seminar on Federally Mandated OSHA, to be held from 1:00 p.m. to 3:00 p.m. on March 18, 2020 at Kean University in Union. For more details and to register, click here.

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