Close family members of people who die from coronavirus will be allowed attend their funerals, but only under strictly controlled conditions, according to new guidelines.
Families will be able to say goodbye to their loved ones in the coffin but will not be allowed to kiss the deceased.
They can opt for cremation but this is not required for infection control, according to the interim guidelines for funeral directors published by the HSE.
Last Monday, the Irish Association of Funeral Directors provoked controversy when it said all funeral services for coronavirus victims should be postponed, and the deceased brought straight to the crematorium or cemetery for committal. It also recommended banning family members from funeral homes and from limousines for transport.
The new guidelines take a more permissive approach, though strict infection control rules are laid down.
After death, the human body does not “generally” create a serious health hazard for Covid-19 infection, according to the document.
The virus spreads from person to person when someone coughs and sneezes, sending droplets from the nose or mouth, it points out.
“It is also possible that the act of moving a recently deceased individual might be sufficient to expel a very small amount of air and viral droplets from the lungs and thereby present a minor risk.” However, by staying one metre away from someone with the infection, people will not be within the likely range of droplet transmission.
All funeral staff should use standard precautions “as a matter of course”, treating all human remains as though potentially infected.
Funeral services are included in the public gatherings that are not recommended for people with respiratory illness, under the Government measures introduced on Thursday.
The new guidelines say it is “possible” close contacts of the deceased may have been exposed to Covid-19 infections, and so funeral staff should limit their physical interaction with them through physical separation from members of the public of at least one metre. They should also avoid handshaking, ask families to designate a single point of contact and carry out conversations by phone where possible.
Hand sanitiser and tissues should be provided at funeral homes and other venues.
The document says it is understandable those handling the remains will be concerned and may wish to be made aware of the patient’s infectious status.
It says embalming is not recommended but washing or preparing the body is “acceptable” if those carrying out the task wear long-sleeved gowns, gloves, a surgical mask and eye protection.
Bodies should be placed in a body-bag before being transported to the mortuary, with a face-mask placed over the mouth of the deceased before lifting the remains into the bag.
Those handling the body and placing it in the bag should wear full protective gear.
“Once in the hospital mortuary, it would be acceptable to open the body bag for family viewing only,” says the document. However, the family should be advised not to kiss the deceased and should clean their hands after touching the body.
Waking at home is being advised against.
In the funeral home, the deceased should be removed to a designated area. While the hearse is unlikely to suffer any significant contamination if should be cleaned.
“In the current situation it is likely that only a few key people close to the deceased will attend the funeral home,” say the guidelines.
“In exceptional circumstances where family members have not had the opportunity to view the remains in the hospital mortuary the coffin can be opened. Staff must wear appropriate PPE (personal protective equipment) to open the bag and fold it back leaving head, shoulders and arms exposed.”
Funeral directors are being told to avoid any direct contact with any family member identified as a close contact of the deceased.
For the funeral, where the family members and friends are not close contacts they may attend and the funeral can proceed as usual, although the coffin should remain closed and sealed.
In a different scenario, where close contacts wish to attend, “the arrangements and feasibility of this should be discussed with the family and service providers sensitively beforehand”.
The close contacts should be advised to use private transport to travel to the funeral and to avoid contact with people other than members of their own household.
The document says: “The funeral should be private and limited to those that the family identify as essential.”
Social distancing of at least one metre should be observed and those attending should be aware of the importance of regular hand hygiene and good cough etiquette. Direct contact between groups “is not advised”.
“It is a sensible measure to suspend the use of condolence books and recommend people issue condolences through social media, online websites such as rip.ie, text or by letter.”
In the funeral home or church, the coffin should remain closed, and only a “small number of people” should pay their respects.
“The option of cremation is at the discretion of the family but is not required for the purposes of infection prevention and control.”