Precautionary strategies should be used to minimise public health risks and to prevent spread of disease:
- Contact and droplet precautions should be used when handling deceased bodies confirmed or suspected to have COVID-19.
- When handling deceased bodies wear appropriate PPE at all times without contaminating environmental surfaces.
- For transport and storage the body must be placed and secured in a bag or wrapping in a manner that prevents leakage; double bagging may be required to achieve this.
- The body bag should be labelled “COVID-19 – Handle with care”.
- Avoid unnecessary manipulation of the body that may expel air or fluid from the lungs.
- Embalming of a body confirmed or suspected to have COVID-19 is not recommended.
- Family viewing of the deceased may occur; however, family members should avoid any contact with the body, if contact occurs advise to perform hand hygiene.
- Maintain the recommended social distance from families and friends of the deceased.
What is the COVID-19 virus?
COVID-19 is a disease caused by a new strain of coronavirus, SARS-CoV-2, that has not been previously identified in humans. It was first identified in Wuhan, Hubei Province, China, where it has caused a large and ongoing outbreak. Cases have since been identified in several other countries, including Australia.
COVID-19 is spread through droplets produced when an infected person coughs or sneezes, or by indirect contact with contaminated hands, surfaces or objects. People are at risk of infection if they come in close contact (face to face for at least 15 minutes or in a closed space for at least 2 hours) with someone who has COVID-19.
Risk to funeral directors and mortuary personnel
There is no evidence of an increased risk of transmission of the virus that causes COVID-19 to funeral industry workers who handle the bodies of those suspected of having, or confirmed to have, died from COVID-19. The greatest risk is likely to come from failure to employ infection prevention and control measures and contact with family members.
For more information on stopping the spread, visit Department of Health - Launch of the coronavirus (COVID-19) campaign.
Funeral industry personnel should however employ infection prevention and control measures when handling bodies. Further information is available in the NSW Infection Prevention and Control Policy (PD2017_013).
Preparing to manage bodies with COVID-19
Before accepting deceased persons with COVID-19, funeral directors should review their own infection prevention and control policies and procedures and ensure staff are familiar with these practices. This may include providing training in hand hygiene and how to put on and remove PPE.
Precautions while handling the body
- Avoid unnecessary manipulation of the body that may expel air from the lungs.
- Always adhere to standard precautions and wear appropriate PPE while handling the body.
- Practice hand hygiene practices before and after contact with the body.
- Perform regular environmental decontamination including all surfaces and equipment with a detergent and disinfectant or dual-purpose product included in the Australian Register of Therapeutic Goods as a listed disinfectant with a specific virucidal claim (“kills viruses”).
Personal Protective Equipment (PPE)
Standard infection prevention and control, occupational health and safety guidelines should always be followed while handling and preparing a body. All staff should be trained in the correct use of PPE.
Persons in close contact with the body must wear:
- a clean protective outer garment, such as a gown (impervious or fluid resistant disposable gown)
- disposable gloves
- a disposable surgical mask
- appropriate eye protection such as safety glasses or a face shield.
After use, PPE should be carefully removed and decontaminated (if reusable) or disposed of into general waste as soon as practicable.
Aerosol generating procedures
The potential for airborne spread of COVID-19 is still unknown. Aerosol generating procedures should be avoided if possible. Airborne precautions should be employed when performing aerosol generating procedures, such as postmortem use of oscillating or fast-spinning power tools.
Airborne precautions include:
- disposable fluid resistant long-sleeved gown
- P2/N95 respirator (mask) – should be fit checked with each use
- face shield or safety glasses
- disposable nonsterile gloves when in contact with patient
- hand hygiene before donning and after removing gloves.
For more information, visit Clinical Excellence Commission - Transmission-Based Precautions.
When transporting the deceased, the body must be placed and secured in a bag or wrapping in a manner that prevents the leakage of any body exudate or other substance. Double bagging may be required to achieve this.
The body bag should be clearly and permanently labelled “COVID-19 – Handle with care”.
The funeral director should only remove the body to prepare the body for viewing, cremation or burial.
Used body bags should be disposed of in clinical waste streams.
Handling of bodies
Persons who may handle deceased persons with COVID-19, such as funeral directors and morgue attendants, must comply with the guidelines specified in Part 3 of the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019) as published by the National Health and Medical Research Council. When placing a body in a bag or wrapping, a person must comply with standard infection prevention and control procedures consistent with the NSW Infection Prevention and Control Policy (PD2017_013).
Transportation of bodies
The owner or driver of the vehicle used to transport the deceased should be informed that the body is confirmed or suspected to be infected with COVID-19.
There is no change to the usual body transport protocols for COVID-19 related deaths.
Embalming is not recommended for bodies who died from, or with, COVID-19 as it is not clear whether embalming is safe to do.
If embalming must be done, the embalmer should be certified and trained in the use of PPE consistent with contact and airborne precautions. This includes a P2/N95 respirator (mask) which has been fit-checked, gown, gloves and eye protection.
Viewing the body
Family or relative viewings of the deceased should be allowed to take place in a funeral director’s mortuary facility after the body has been prepared.
Standard infection prevention and control precautions should be observed. Family members should not kiss or touch the deceased to minimise the risk of transmission.
If a family member does touch the body, they should wash their hands with soap and water immediately afterwards or use an alcohol-based hand rub.
To minimise transmission of COVID-19, funeral directors must comply with all Public Health Orders relating to gatherings. From Friday, 24 July 2020, the maximum number of people who may attend a funeral or memorial service or a gathering following a funeral or memorial service, is the lesser of one person per 4 square metresor 100 people. Funerals at outdoor public places or a place of residence are subject to the same limits.
Places of public worship, funeral homes or crematoriums can have up to 50 attendees (without the 4 square metre rule) provided non-household contacts can maintain 1.5 metres of physical distance.
However, as the home is a high transmission area, the NSW Chief Health Officer strongly recommends a COVID-Safe precautionary approach of limiting visitors to the home to 10 people as a general principle.
People attending the service will be required to supply their name and contact details so that they can be used for contact tracing.
For up-to-date information on Public Health Orders related to public gatherings, see Public Health Orders and restrictions.
Cremation of bodies
Funeral directors must comply with the relevant NSW Public Health Regulations with regards to disposal of bodies. Infection prevention and control precautions should be used during body handling and the cremation of deceased bodies confirmed or suspected to have COVID-19.
Removal of implanted medical devices is not recommended for bodies who died from, or with, COVID-19 as it is not clear whether it is safe to do.Cremation practices should be managed accordingly. If the device must be removed, the person removing it should be certified and trained in the use of PPE consistent with contact and airborne precautions. This includes a P2/N95 respirator which has been fit-checked, gown, gloves and eye protection.
Original publication date
18 March 2020
Original: Environmental Health Branch
- Revision: Strategic Reform and Planning Branch
NSW Health Pathology
- Infection Prevention and Control, NSW Clinical Excellence Commission
- Health Protection NSW
Dr Nigel Lyons, Deputy Secretary, Health System Strategy and Planning
1 July 2020
Health Protection NSW
- NSW Health Pathology
- Infection Prevention and Control, NSW Clinical Excellence Commission
For use by
Private funeral industry.