Important Advisories:
- Your local and/or state public health officials may be making recommendations that are more stringent than what the CDC has recommended. In these cases, you should defer to your state and/or local public health officials.
- The CDC guidance represents the minimum precautions a funeral professional should take while caring for the body of someone who died of confirmed or suspected COVID-19. You should use your best professional judgement to determine whether you should take additional precautions beyond what is recommended by the CDC.
On April 1, NFDA shared information regarding alternate guidance from the World Health Organization(WHO) on embalming individuals who died of confirmed or suspected COVID-19. NFDA immediately reached out to the CDC to clarify what guidance funeral professionals in the United States should follow. Today, NFDA learned the CDC stands by its recommendation that pandemic victims can be safely embalmed so long as the funeral professional follows proper safety protocols.
In their response to NFDA, the CDC noted that WHO is a global health organization and it issues broad guidance for countries ranging from those that are undeveloped/underdeveloped to those that are advanced/developed.
This means guidance WHO issues can be conservative to help protect individuals in countries where safety standards, protocols and training may not be as comprehensive as the United States.
The CDC noted that funeral directors in the United States have appropriate training, credentials and experience to safely embalm decedents with viral bloodborne pathogens, such as COVID-19, by using currently accepted standards of care and standard operating procedures consistent with OSHA regulations.
Implementing these standard operating procedures and general industry practices and standards of care should minimize hazards inherent in embalming and protect funeral home workers.
In affirming the safety of embalming victims of confirmed or suspected COVID-19, the CDC noted:
- Proper PPE should be used (e.g. disposable gown, faceshield or goggles, and facemask). If aerosols are likely to be generated, then respiratory protection (e.g., NIOSH-approved N-95 respirator or higher level of protection) should be worn.
- See: CDC recommendations about selecting appropriate PPE.
- Additional information about PPE for aerosol-generating procedures can be found in the CDC’s Postmortem Guidance (see the section “PPE Recommendations for Autopsies”).
- Noted embalming experts have created videos for funeral professionals explaining safety protocols, including how to minimize aerosolization of fluids.
- The CDC indicated one control option may be to embalm without aspiration to minimize the production of aerosols.
- While guidance for autopsies recommends negative-pressure isolation rooms as a first choice, most funeral homes do not have those types of rooms. In the absence of isolation rooms, when aerosols may be generated, the CDC offers other recommendations, such as keeping the door to the prep room closed.
- The CDC offers other environmental controls in its Postmortem Guidance (see the section “Engineering Control Recommendations for Autopsies”).
- Funeral home owners and managers should know the importance of OSHA requirements to conduct hazard assessments/risk determinations to prevent workers’ exposure to health and safety risks. If risks cannot be controlled using the hierarchy of controls approach, then the procedure(s) should not be conducted because the risks may not be properly managed.
- Another administrative control that should be considered is whether funeral directors over the age of 65 or with preexisting medical conditions should embalm confirmed or suspected COVID-19 cases.
The CDC noted its appreciation of the summary of its guidance on NFDA’s COVID-19 Information Hub.