Funeral Guidance for Individuals and Families And Covid 19 – CDC

Grieving the loss of a loved one during the fear and anxiety about the COVID-19 pandemic can be overwhelming. It may be difficult for people to make decisions about how to safely grieve and honor their loved one.

This guidance is for individuals and families as they work with funeral directors, community and religious leaders, and others to plan and hold funeral services and visitations during the COVID-19 pandemic.

Help lower the risk of spreading COVID-19 by following these guiding principles.

Guiding Principles

• The more people interact, the closer in distance the interaction is (less than 6 feet), and the longer the interaction lasts, the higher the risk of spreading COVID-19.
• The higher the level of community transmission in an area, the higher the risk of spreading COVID-19.
• Cloth face coverings help lower the risk of spreading COVID-19, particularly if social distancing cannot be maintained.
• During an in-person gathering, convene in outdoors or in well-ventilated areas, if possible, rather than poorly ventilated, indoor areas to help lower risk of spreading COVID-19. Outdoor gatherings are safer than indoor gatherings.
• Avoid sharing commonly used objects such as religious aids (e.g., religious books, collection plates, programs, etc.,) to help lower the risk of spreading COVID-19.
• Reducing the number of people who are engaged in activities like singing or chanting as these behaviors can increase the amount of respiratory virus in the air.
• Practice increased hand hygiene, and cleaning and disinfection of frequently touched surfaces and objects to help lower the risk of spreading COVID-19.
• Practice social distancing by maintaining at least 6 feet between attendees; facility or lay staff; and clergy or officiants, especially when small, in-person services are held.
• Take extra precautions for those at increased risk for COVID-19, particularly those who are older or have pre-existing conditions, to help lower the risk of spreading COVID-19.

The risk of COVID-19 spreading at gatherings and services is ranked as follows, from lowest to highest:

Lowest risk: Virtual-only services and gatherings.

Lower risk: Smaller outdoor, in-person services and gatherings in which individuals from different households remain spaced at least 6 feet apart, wear cloth face coverings, do not share objects and come from the same local area (e.g., community, town, city, or county).

Higher risk: Medium-sized in-person services and gatherings, either indoors or outdoors, adapted to allow individuals to remain spaced at least 6 feet apart, with some individuals wearing face cloth coverings and with some attendees coming from outside the local area. The sharing of items or objects is limited.

Highest risk: Large in-person services and gatherings held indoors and where it is difficult for individuals to remain spaced at least 6 feet apart; many attendees travel from outside the local area. Few individuals wear cloth face coverings and objects are shared.

In some situations, many people have become sick with COVID-19 after attending a funeral service. To help prevent the spread of COVID-19 in communities, changes need to be made to the way funerals, visitations, and memorials to the deceased are held. This guidance provides strategies to protect yourself and others when you are grieving the loss of a loved one, supporting each other, making funeral arrangements, and participating in funeral services and visitations. Some examples include:

• Using technology to connect virtually with family and friends during the grieving process.
• Considering modified funeral arrangements, such as limiting attendance at funerals held during shortly after the time of death to a small number of immediate family members and friends; and then holding additional memorial services when social distancing guidelines are less restrictive.
• Practicing social distancing by maintaining at least 6 feet between attendees, facility staff, and clergy or officiants when small, in-person services are held.
• Considering modifications to funeral rites and rituals (for example, avoid touching the deceased person’s body or personal belongings or other ceremonial objects) to make sure of everyone’s safety.
• Wearing cloth face coverings while around others and outside of your home.

Grieving the loss of a loved one

Grief is a normal response to losing someone important to you. When a loved one dies, it is important for friends and family to be able to share stories and memories of the person and how they influenced their lives. The COVID-19 pandemic has affected the ability of friends and family to come together in person and grieve in typical ways. This is true regardless of whether the person’s death was due to COVID-19 or some other cause.

Given the COVID-19 pandemic, hosting gatherings now could be dangerous to those who would want to participate. Family and friends are finding alternate ways to connect, support each other, and grieve after their loss. They understand the need to possibly plan for additional memorial services when COVID-19-related restrictions are lifted.

Take actions to help you cope with the loss of a loved one

Grief is a universal emotion, but no two people experience grief in exactly the same way. Some actions you can take to help you cope with feelings of grief while practicing social distancing and honoring your loved one include:

• Invite people to call you, or host conference calls with family members and friends to stay connected.
• Ask family and friends to share stories and pictures with you via phone, video chat, email, text message, photo sharing apps, social media, or mailed letters.
• Create a virtual memory book, blog, or webpage to remember your loved one, and ask family and friends to contribute their memories and stories.
• Coordinate a date and time for family and friends to honor your loved one by reciting a selected poem, spiritual reading, or prayer from within their own households. Some cultures practice a prolonged mourning period with multiple observances, so hosting virtual events now and in-person events later may be in keeping with these practices.
• Seek spiritual support from faith-based organizations, including religious leaders and congregations, if applicable. People who are not part of a faith tradition or religious community can seek support from other trusted community leaders and friends.
• Use grief counseling services, support groups, or hotlinesexternal icon, especially those that can be offered over the phone or online, or seek support from a mental healthcare provider.
• Read books about grief and loss. If you have children, read age-appropriate books with them and talk with them about how they are feeling.
• Take part in an activity that has significance to you and the loved one you have lost, such as planting flowers or a tree or preparing a favorite meal, in memory of your loved one.
• Review additional information from CDC on loss and grief, and ways to cope with stress and anxiety.

During the COVID-19 pandemic, the family and close friends of a person who died of COVID-19 may experience stigma, such as people avoiding them or rejecting them. Stigma hurts everyone by creating fear or anger toward other people. Some people may avoid contact with you, your family members, and friends when they would normally reach out to you. You can help stop stigma related to COVID-19 by knowing the facts and sharing them with extended family, friends, and others in your community.

Practice social distancing while making funeral arrangements

• Consider having virtual or phone meetings instead of in-person meetings with funeral home staff, cemetery staff, clergy or officiants, and others to plan funeral arrangements.
• If you need to meet in person, follow everyday preventive actions to protect yourself and others from COVID-19, such as wearing a cloth face covering, social distancing, washing your hands often, and covering coughs and sneezes.
• Do not attend in-person meetings if you are sick or if you might have been exposed to COVID-19. Those who have a higher risk of severe illness should weigh the benefits of in-person attendance against the risk of exposure to a person with COVID-19, especially if recommendations for wearing cloth face coverings and social distancing may be difficult to follow for themselves or others.

Discuss options for making changes to traditional funeral plans

• Discuss your cultural or religious traditions and the funeral wishes of the deceased, if applicable, with family members and the people you are working with (funeral home staff, clergy, or officiants).
  • Identify any potential concerns and determine options to make changes to prevent the spread of COVID-19. Preserve traditional practices when it is possible to safely do so, and identify whether modified or new practices could satisfy the needs and values of you and your loved one.
• Consider whether it would be acceptable to hold modified funeral arrangements by limiting attendance to a small number of immediate family members and friends shortly after the time of death. Consider holding additional memorial services in the future when social distancing guidelines are less restrictive.
  • When you are making decisions about who should attend, consider how emotionally difficult social distancing practices might be for attendees (such as keeping at least 6 feet apart and not hugging other attendees who do not live in their household).
• Ask the people you are working with (funeral home staff, clergy, or officiant) about resources they may be able to provide, such as:
  • Virtual funeral services, visitations, and memorial tributes by online video streaming or recorded video. Consider potential issues with virtual attendees’ access to technology and high-speed internet, as well as how any technical difficulties during the service could impact the event.
  • Online guestbooks or memory books that invite people to share stories, notes of condolence, or photos.
  • Assistance with sharing details about the plan for funeral services and visitations with extended family and friends, including how to compassionately communicate any changes to traditional practices and the reasons they are necessary.

Holding funeral services and visitations

Familial and cultural expectations might put pressure on you and others to participate in or hold or schedule funeral services and visitations. During the COVID-19 pandemic, those expectations may need to be relaxed to protect the safety of those who would have participated. People continue to get exposed to COVID-19 at funeral services; the people giving it to others were not feeling sick at the time and did not know they were carrying or spreading COVID-19.

Consider the following modifications to funeral services and visitations to help prevent the spread of COVID-19. These modifications are recommended for events held in any setting, including funeral homes, cemetery facilities, places of worship, private homes, and other venues.

Limit the attendees to a small number of immediate family and close friends

• Follow the guidelines from state and local officials and state and localexternal icon health departments.
• Those who are sick, have a household member or other close contact who is sick. Those who have higher risk of severe illness should weigh the benefits of in-person attendance against risk of exposure to a person with COVID-19, especially if recommendations for wearing  cloth face coverings and social distancing may be difficult to follow for themselves or others
• Consider limiting the number of people from different areas of the country or any areas with significant spread of COVID-19.
• Consider offering other ways for family and friends to participate, such as by phone or online (live or recorded).

Practice social distancing and everyday preventive actions

• Consider holding services and gatherings in a large, well-ventilated area or outdoors, as circumstances and traditions allow.
• Space out seating for attendees who do not live in the same household to at least 6 feet apart between household groups.
• Attendees who do not live in the same household should stay at least 6 feet (2 meters) apart and wear a cloth face covering when interacting with people who do not live in their household.
• People who have been living in the same household can comfort each other in typical ways such as hugging, holding hands, and sitting next to each other.
• Attendees should nod, bow, or wave instead of holding or shaking hands, hugging, or kissing anyone who does not live in their household.
• Consider limiting the number of people engaged in activities that produce respiratory droplets, which may contain virus, (e.g., singing or chanting) especially when participants are indoors and in close proximity to each other. If attendees choose to sing or chant, encourage them to wear cloth face coverings and increase the distance between people to greater than 6 feet.
• All attendees should follow everyday preventive actions to protect themselves and others from COVID-19, such as washing your hands often and covering coughs and sneezes.

Consider changing traditional rituals or practices

Discuss with the funeral home director, clergy or officiant, and your family any potential changes that might be necessary to protect all of the participants and attendees. Consider options for modified or new practices that would be acceptable to you and your family and friends, such as:

• Holding a graveside-only service.
• Changing or removing funeral practices that involve close contact or sharing things among members of different households, such as:
  • Sharing a car or limousine ride between the church and cemetery.
  • Providing food and beverages for attendees after the service.
• Changing religious rituals in consultation with clergy and other religious leaders.

If some traditions, such as certain religious rituals, sharing rides to the gravesite, or having food and beverages, are considered essential to you and your family and friends, consider modifying them.

• Limit sharing of items, such as worship aids, prayer books, and other items shared or passed by clergy and attendees during religious rituals.
• Group household members together inside the vehicle. Avoid having non-household members sharing vehicles to travel between locations during the services; if necessary, increase ventilation by opening windows or using the air conditioner on non-recirculating mode.
• If food is offered at a reception, have individual pre-packaged boxes or bags instead of a potluck, buffet, or family-style meal. Avoid sharing of foods and utensils.

In some cultures, bringing food or gifts to grieving family members is an important way to express care and concern. During the COVID-19 pandemic, consider expressing care in ways that do not involve personal interactions. Consider delivering food or gifts to grieving family members in ways that keep people at least 6 feet apart, mailing care packages, or giving families gift cards for food delivery services.

Avoid touching the deceased person’s body before preparation

There are many different cultural traditions involved in the bereavement process, including some that involve touching the deceased person’s body before preparation. Though we are still learning more about how COVID-19 spreads, it may be possible that you could get COVID-19 by touching the body of a deceased person who had confirmed or suspected COVID-19 prior to the body being prepared for viewing. After the body has been prepared for viewing, there may be less of a chance of the virus spreading from certain types of touching, such as holding the hand or hugging.

Take steps to protect yourself, such as:

• Avoid touching, hugging, or kissing the body of a deceased person who had confirmed or suspected COVID-19 before and during body preparation, especially if you or a member of your household are at higher risk of severe illness from COVID-19.
• Wash your hands with soap and water for at least 20 seconds after any contact with the body. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol.

Take precautions with rituals that involve touching the deceased person’s body

If the deceased person had confirmed or suspected COVID-19, avoid kissing, washing, or shrouding the body before, during, and after the body has been prepared, if possible. Take precautions if participating in these activities is part of important religious or cultural practices.

• Work with your cultural and religious leaders and funeral home staff to identify how to reduce exposure as much as possible.
• People at higher risk of severe illness from COVID-19 and members of their household should not be involved in these activities.
• People conducting these activities should wear disposable gloves (nitrile, latex, or rubber). Additional protective equipment may also be required, such as disposable and waterproof isolation gowns, face shields or goggles, and facemasks (e.g., if splashing of fluids is expected).
• Following preparation of the body, safely remove gloves (and other protective equipment, if used) and throw them away. Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol. Shower as soon as possible.
• If you did not wear an isolation gown while preparing the body, wash your clothes in the warmest setting possible and dry them completely.
• If removing personal possessions (such as wedding rings) from the body or casket, clean and disinfectexternal icon the items and wash hands right away.

Safely gather your loved one’s belongings

If desired, you may retrieve the belongings of a loved one who has died of COVID-19 outside their home (for example, in a hospital setting). Depending on local rules and regulations, family members may retrieve these belongings at the funeral home or the healthcare facility.

You should use gloves and practice good hand hygiene when handling your loved ones’ belongings. Depending on the type of belongings, such as electronics, you should also follow the household item-specific cleaning and disinfection guidelines when handling these items.