Governments prepare for pandemic deaths

Health officials are preparing for a possible surge in COVID-19 deaths, despite rates falling.
Health officials are preparing for a possible surge in COVID-19 deaths, despite rates falling.

Mortuaries are preparing for a possible surge in COVID-19 deaths during the pandemic, even as Australia shows early success in flattening the curve and the country's death toll remains relatively low.

While overseas countries such as the United Kingdom, China, the United States, Italy and Spain have lost thousands of people to the coronavirus, Australia's death toll sat at 53 on Friday.

The country's infection curve is also trending in the right direction, following the introduction of social distancing restrictions.

But the pandemic has nonetheless prompted changes at funeral homes and forensic facilities, and University of Adelaide pathology professor Roger Byard says "we can't afford to be cavalier about it".

"We are very lucky that our death rate has been very low but that could clearly change quite dramatically, as we have seen in other countries," Prof Byard told AAP.

While the worst-case scenario might not eventuate, authorities have to be prepared.

The funeral sector is expected to have the most contact with those who die from COVID-19.

There's varying advice as to how funeral homes should handle bodies, with federal and state governments issuing guidelines around the use of personal protective equipment, embalming, viewings and certain cultural practices.

But some of that advice is "impractical", the National Funeral Directors Association says, and access to personal protective equipment is a concern as funeral staff move through hospitals, aged care facilities and private homes.

"The best advice in the world is useless if you can't get the equipment to meet it," NFDA president Nigel Davies told AAP.

Davies says most funeral directors, cemeteries and crematoriums are running very low on PPE and have to be selective about how they follow guidelines.

Australian Funeral Directors Association vice-president Adrian Barrett argues the industry needs certainty around access to PPE and other supplies, staffing levels and the ability to move freely for funeral-related tasks during travel restrictions.

"We see ourselves in the funeral service as somewhat of the frontline as the virus develops," Barrett told AAP.

"Obviously we're going to have to make sure we have staff and equipment and everything to at least organise the transport, burial and cremation of the deceased."

When it comes to forensic facilities, the situation varies across jurisdictions and institutions, Prof Byard reveals.

In South Australia, the approach to handling bodies has changed, and the requirement to wear PPE has been ramped up.

Bodies are also being tested for COVID-19 before autopsy.

"People say, well, you know, they're dead (but) we don't know how long COVID-19 survives in bodies - nobody really knows that," Prof Byard says.

While forensic facilities generally don't autopsy COVID-19 victims, Prof Byard notes there's still a chance infected people could end up on the autopsy table if, for example, they died during home isolation without being diagnosed.

"If that really spiralled, our resources would be very stretched, so we would have to do things like finding places to store the extra bodies," he says.

"So every forensic facility in the country has sort of a fall-back position where they can actually get containers in or they have another facility to store the bodies."

Every mortuary has a disaster plan that can be adapted for COVID-19, and state disaster identification committees meet regularly, Prof Byard says.

"I think we've done the best we can really, and I think we just have to see how it develops.

"There are so many unknowns at the moment but I really think we're as prepared as we could be and that's a good thing."

Forensic medicine and pathology consultant Professor Peter Ellis knows it's important to look at the worst-case scenario - although he acknowledges Australia has so far handled the situation well.

States and territories are planning for death management during the pandemic.

NSW Health's pathology division is working with partners across the health and justice systems to prepare for a range of outcomes.

"This is to ensure all deceased people in NSW can be safely accommodated in the event a surge in COVID-19-related deaths exceeds existing storage capacity," the health department says in a statement.

New infection control guidelines include information about identifying suspected COVID-19 cases, PPE requirements, the appropriate use of body bags and cleaning.

A spokesperson for the Northern Territory's health department says it's working to develop a management plan for mortuary capacity and support while "engaging with community partners for their valuable input".

"As more is understood about COVID-19, the management plan will be updated to reflect changing options as well as different predictions," the spokesperson says.

Meanwhile, SA Health in a statement reveals it's in the midst of updating information concerning the management of the deceased and infection control risks associated with COVID-19.

The department is also developing a bereavement plan to support community members affected by COVID-19 deaths.

"SA Health continues to work with the funeral industry and South Australian Police to ensure a collaborative approach to managing the deceased during major incidents and disasters."

Australian Associated Press