Handling the deceased with suspected or confirmed COVID-19

This guidance has been developed to ensure that people who come into contact with the deceased through work, or who work in services providing care for the deceased, are protected from COVID-19 infection. This may include people such as funeral directors, mortuary operators, medical practitioners and those involved in transporting the deceased.

Contents

Risk of infection

While the risk of transmission of COVID-19 from the deceased is low there is likely to be a continuing risk of infection from handling body fluids and tissues where infection is suspected or confirmed. The exact duration that SARS-CoV-2 can remain infectious in body fluids and tissues in a deceased body is unknown.

Residual hazard of infection from COVID-19 may arise from:

Standard infection control precautions (SICPs) and transmission-based precautions (TBPs) should be sufficient to protect those handling the deceased with suspected or confirmed COVID-19 while deceased individuals remain in the care environment. This includes under refrigeration conditions.

You can find out more about SICPs and TBPs in HSE publication Managing infection risks when handling the deceased.

The UK Health Security Agency have published a brief update of the rapid review examining risk of COVID-19 transmission from the deceased.

Managing a death in the community (for example funeral directors)

Meeting with the bereaved

Where possible, you should provide support and advice over the phone.

If you need to meet with the bereaved but will not make direct contact with the deceased, follow the public health advice for the nation you’re working in:

Precautions where there is close contact with the deceased

If you are required to have close contact with the deceased, you should take the following precautions:

Further guidance for staff who manage the deceased and those involved in the exhumation of human remains is available in publication Managing infection risks when handling the deceased.

Volunteers

In some communities, deceased bodies are cared for by appropriately trained volunteers. If you are a volunteer with an underlying condition that puts you at higher risk of severe illness if infected with COVID-19, you should consider seeking advice from your health professional on whether you should provide care for the deceased.

Preparations and final disposition

Viewing, hygienic preparations such as washing and post-mortem investigations are permitted when overseen or undertaken by those trained in handling bodies of the deceased.

PPE requirements for mortuary staff, pathologists, pathology technologists, funeral directors and embalmers

While embalming can take place, where aerosols could be generated through the use of high-speed tools or the removal of fixion nails, you should use PPE as indicated in the RCPath and AAPT guidance for autopsy procedures. This is also shown in Table 1 below.

Cremation is permitted and where the deceased has a medical device that requires removal beforehand, use PPE as detailed in Table 1.

Table 1: Transmission-based precautions for suspected or confirmed COVID-19

  Non-autopsy procedures, including admission of deceased, booking-in of deceased, preparation for viewing, release of deceased Autopsy procedures, including other invasive procedures

Disposable gloves

Yes

Yes

Disposable plastic apron

Yes

Yes

Disposable gown

No

Yes

Fluid-resistant (Type IIR) surgical mask (FRSM)

Yes

No

Filtering face piece (class 3) (FFP3) respirator

No

Yes

Eye or face protection (may be single or reusable face or eye protection, full face visor or goggles)

Yes

Yes

Employees should:

RCPath and AAPT have published guidance on the PPE requirements for care of the deceased during the COVID-19 pandemic.

The UK Health Security Agency (UKHSA) has guidance (including posters and videos) on putting on and taking off PPE.

If you process samples taken from bodies you should follow guidance in the section on ‘Managing Risks from Infection in Post Mortem Room and Mortuary’ in the publication Managing infection risks when handling the deceased.

Management of cleaning and waste

Advice on cleaning and disinfection for the mortuary and similar workplace environments is available in HSE publication Managing infection risks when handling the deceased with specific reference to appendix 3. You should read this in conjunction with the Department of Health guidance.

Precautions for others who are involved in the care of the deceased

Staff involved in the care of the deceased outside of the formal funeral home or mortuary setting should consider what actions they need to take to ensure safe working.

We strongly advise that any rituals or practices that bring people into close contact with the deceased with suspected or confirmed COVID-19 should be undertaken using appropriate PPE under supervision of somebody trained in its use.

Table 2 below details activities involved in the care of the deceased and the appropriate PPE required.

Table 2: PPE requirements for care of the deceased in non-clinical settings

  Disposable gloves (single use) Disposable plastic apron Disposable gown Fluid-resistant surgical mask (FRSM) Eye protection (read note below table)

Death verification

Yes

Yes

No

Yes

Risk assess

Moving the deceased

Yes

Yes

No

Yes

Risk assess

Washing the deceased

Yes

Yes

No

Yes

Risk assess

Preparing for transportation, for example, shrouding, placing in a body bag or coffin

Yes

Yes

No

Yes

Risk assess

Transporting the deceased in a body bag or coffin or cloth wrapping

No

No

No

No

No

Note: eye or face protection (full face visor or goggles) is recommended only if there is an anticipated/likely risk of contamination with splashes or droplets of blood or body fluids.

Transporting the deceased

Cloth wrappings (shrouds or wraps) and coffins may also be used to manage the risk of contact transmission but are not a replacement for body bags in situations where they are recommended.

If neither body bag nor coffin has been used, cleaning and disinfection of the vehicle should be sufficiently thorough to prevent transmission. 

More guidance

The guidance above has been co-created with UKHSA, and should be read in conjunction with the following:

Managing infection risks when handling the deceased

This HSE publication details the standard infection control precautions and transmission-based precautions that should be followed by all those handling the deceased. It covers the safe handling, storage and examination of bodies in hospitals, mortuaries and post-mortem rooms. The guidance is not specific to COVID-19 but the SICPs and TBPs described are sufficient for managing the risk, with additional precautions taken for aerosol generating procedures (AGPs). Paragraphs 12 to 18 give details on the related legal duties which apply.

Transmission-based precautions: Guidance for care of deceased during COVID-19 pandemic.

Royal College of Pathologists (RCPath) and Association of Anatomical Pathology Technology (AAPT) guidance, which details the Personal Protective Equipment (PPE) required for TBPs that should be used by any professional involved in the care of the deceased during the COVID-19 pandemic.

 
Updated 2022-07-12