funeral directors

There is much discussion in funeral world about whether funeral directors should be prioritised for vaccination as ‘frontline workers’. Indeed, we have heard that some celebrants are also enquiring as to whether they too should be considered a priority to be vaccinated against the virus which has ravaged our lives for the last year.

For background, the Joint Committee on Vaccination and Immunisation (JCVI) has a very clear list of priorities for vaccination in phase 1, which is currently underway :

1. residents in a care home for older adults and their carers
2. all those 80 years of age and over and frontline health and social care workers
3. all those 75 years of age and over
4. all those 70 years of age and over and clinically extremely vulnerable individuals
5. all those 65 years of age and over
6. all individuals aged 16 years to 64 years with underlying health conditions which put them at higher risk of serious disease and mortality
7. all those 60 years of age and over
8. all those 55 years of age and over
9. all those 50 years of age and over

JCVI does not advise further prioritisation by occupation during the first phase of the programme, noting that, “This prioritisation captures almost all preventable deaths from COVID-19, including those associated with occupational exposure to infection.”

This week, Health Secretary Matt Hancock said that ministers will consider whether key workers such as police, teachers and essential shop staff should be prioritised once the most vulnerable have received the coronavirus vaccine, and Metropolitan Police Commissioner, Dame Cressida Dick has said she is ‘baffled by the government’s decision not to prioritise police offers and is in ongoing discussion with government to try and change their position.

Understandably, people working within the funeral sector are anxious. A petition has been created to ‘Prioritise funeral workers for COVID vaccine’. It’s not specific as to whereabouts funeral workers should come on the list,  asking that ‘parliament ‘recognise that we are frontline workers and we are at risk every time we go to work and put us as a priority to have the vaccine ASAP’.

This has attracted some interest from the media, and one of our Recommended Funeral Directors was contacted this week for comment. We invited her to share her thoughts about vaccine priority on the blog in a guest post. Your comments or thoughts are very welcome.

Guest blog post from Lucy Coulbert, owner of The Individual Funeral Company

“Should funeral directors be prioritised for a Covid vaccine?”

This wasn’t even a question I was asked by a BBC researcher. What they actually asked was “What are your thoughts on the petition to government to have funeral directors vaccinated as key workers.”

I’ll be honest; I really don’t understand why the traditional funeral associations were pushing for funeral directors to be given priority for vaccinations.

Are we at risk? Only to a very small extent. When we go to a hospital mortuary, we follow the government guidance to the letter concerning PPE. The risk to us is extremely low.

This is because the hospital would have tested people for Covid-19 and if they were positive at the time of their death, they are placed in a body bag before we collect them.

We aren’t allowed to enter our local hospital without a mask at all. Before I even get out of my vehicle, my mask is on and so are my gloves.

When we go to a care home or someone’s own home, I completely disregard the government guidance on wearing a “fluid resistant face mask” in favour of an FFP3 mask which is the best grade of mask money can buy.

We wear a full white paper suit which also covers our hair, shoe covers, a long sleeve plastic apron, gloves, FFP3 mask and a face shield. This is above and beyond what the government recommend.

We do this because we treat ourselves as if we have Coronavirus and we want to protect the staff in the care homes & residents along with a person’s family if they died at home.

Guidance for care of the deceased with suspected or confirmed coronavirus (COVID-19) – GOV.UK (www.gov.uk)

When we go into these settings, including into care homes which have had a Covid outbreak, the exposure we have to Coronavirus is low because we are there for less than 30 minutes unlike doctors and nurses who are exposed for hours on end even with the best masks.

So why should funeral directors essentially be allowed to queue-jump when our risk is low? Honestly, I have absolutely no idea other than it being some kind of vanity or there is some kind of perceived “prestige” in being labelled a key worker.

Neither of those things should mean we get to jump the queue.

Because this is the reality. If we are jumping up the queue to be vaccinated, then other people have to move down.

This isn’t us being vaccinated along side of those who should be. It is us being vaccinated instead of someone else.

At 38 years old and in relatively good health, am I more important to vaccinate than my 90 year old grandmother? Am I more important to vaccinate than a care home staff member or a social worker? Am I more important than a hospital chaplain or my asthmatic next door neighbour? Am I more important than a supermarket worker or hospital porter?

The answer is no. I should be far down the list of people who should be vaccinated.

My GP sent me a text to say if you are a healthcare worker to please call them. I did. I explained I am a funeral director but I also told them I didn’t feel I was in any way a priority.

There have been instances whereby vaccines would go to waste because someone took them out of the freezer too early. I told them if that happened and they didn’t want it to be wasted, to call and I would go but that would be the only way I would attend an appointment without it being my turn.

In March 2020 a week before the government decided to finally introduce a national lockdown, I asked my assistant to work from home. Within 24 hours, she had a brand new laptop delivered to her door.

My other members of staff were given instruction on how to don and doff PPE safely including how to make sure their masks should fit correctly.

They were all asked again if they had any medical conditions I needed to know about and they were all given the option of not working at all.

This was a really frightening time because we really didn’t know enough about what we were being asked to face. I had to ask my staff if they wanted to continue with their duties because given we were facing the unknown, I didn’t want them to feel as though they had to face it with me.

They were all in agreement to keep working and so I set up an A Team and B Team. This was simply so that should any member of the A Team test positive for Coronavirus, I still had a full team of people who could continue on with their duties without there being even the slightest hint of disruption to our clients.

They were all instructed that if they felt ill, even if they didn’t think it could be related to Coronavirus, then they had to tell me immediately and book a test.

While I had an A Team and B Team, I also spoke with other professional work colleagues and made agreements with them that should anything happen to both of my teams of people, would they be prepared to help.

With them on board, that meant I had a core staff of 5 people and then three back-up plans.

So with all of the PPE, teams of staff and two emergency back-up plans, I felt we were ready for anything we had to face.

Nine months on, those plans are still in place and I have gone even further. Only one staff member that I work with regularly is allowed inside my office and only when required.

Our bearers aren’t allowed in my office at all and haven’t been allowed for quite some time.

Since this new lockdown came into force, I was in touch with all of the staff and reminded them that although it feels different this time (much less strict than the first lockdown if the cars and people passing my office are any indication) I need them to remember we are still in the midst of a pandemic and unless they are shopping for food or seeking medical attention, they really need to stay at home.

Now, given I am a small and bespoke company, I don’t really understand why I can put all of these measures in place, prepare my staff and have the best PPE available and other companies can’t.

The only way people contract Coronavirus is by not washing their hands, not wearing a face covering and not social distancing.

There is no other way of contracting it.

Where there are outbreaks of Covid in funeral directors, I have to ask myself how that happened.

Why are their client’s services being interrupted when it is easily avoidable?

The week before I split up my staff last year, we were attending a service at the crematorium. All of my staff, including me, were wearing FFP3 masks and black disposable gloves.

Looked terrible but I had a long conversation with my clients at the time and explained why it was important that we do.

They completely understood and actually thanked us for keeping them in mind and for doing what we could to keep them safe.

While we were waiting for a last family member to arrive, I looked across the car park and there was a funeral director sat in his van filming us. I assume it was so he could show everyone back at the company he worked for what we were doing and how stupid we all were.

Now the crematorium has said no one can enter the chapel without a mask or gloves.

So my point is, if I can have all of this in place and pre-empt what will be required of us next, enough so that it is already second nature already, why can’t everyone else?

With this vaccination queue-jump, it almost feels like companies want the government to solve a problem they created by not putting proper steps in place, possibly not the correct PPE and certainly no emergency planning if their clients are affected.

No person is any more important than the next simply because of the job we do.

I’m afraid the people who decided they would campaign to get funeral directors vaccinated early have really missed the point and I believe they have done it for reasons I can’t fathom.

Any funeral director willing to be vaccinated early rather than wait their turn should ask themselves “Who had to wait so I could have this?”

In the end, this vaccine needs to be getting to the very most vulnerable people in our society. For what it is worth, I would gladly give up my space in that queue for anyone who needs it more than I do rather than playing Funeral Director Hunger Games for a jab.

These are unprecedented times. Across the world, the Covid-19 pandemic sweeps everything before it, heralded by fear and confusion at conflicting government advice, with daily updates of the tens of thousands of people who have become ill, and rising numbers of deaths.

 And while much concern is rightly directed towards the wellbeing of the frontline medical staff battling to support and save the lives of people who are most severely ill, those in the funeral sector are waiting for consistent and clear advice about how to deal with people who have died – who may or may not be carrying the virus.

Currently, there are conflicting official documents relating to handling the bodies of people who have died who have been identified as testing positive for Covid-19, which is now a notifiable disease. (Details of the varying official advice as to levels of PPE required are at the end of this post.)

The guidance we shared from Public Health England in our blog post of March 2^nd has now completely changed – something which we find inexplicable given the vast increase in numbers of people who have tested positive in the last two weeks, and the steady increase in the number of deaths.

14 days ago, Public Health England recommended full PPE, the use of a body-bag and disinfecting all external surfaces prior to moving the body of someone who has died who had tested positive for Covid-19.

Now, the official advice is now that ‘there is no requirement for a body-bag and viewing, hygienic preparation, post-mortem and embalming are all permitted’.

At the time of writing, Public Health England are prioritising testing and not testing either people who are symptomatic at home, or those related to a person who has tested positive.

It is, therefore, entirely possible that people who have died at home may have contracted Covid-19 prior to death but not been tested for it. Equally, it is entirely possible that funeral staff will come into close contact with bereaved people who may be carrying the virus when making arrangements for or carrying out a funeral. None of us know whether the virus is spreading among people as yet asymptomatic in our communities. Logic indicates that we should therefore assume that it is.

Until such time as there is consistent official advice to the funeral sector, and given the acceptance by the government that there are likely to be significant numbers of people in the community currently carrying the virus, potentially without displaying symptoms, we feel that we should be erring on the side of caution, particularly given the close exposure funeral staff can have to those in their care.

The Good Funeral Guide would therefore like to make the following suggestions to funeral directors and staff.

• Assume that everyone in your company, all those in your care, all of the clients you are working with and everyone you encounter during daily activities could be carrying the Covid-19 virus. Put in place as many mitigating procedures as you possibly can.
• Risk assess your daily operations in the light of this fast-developing situation: Have you got adequate handwashing facilities for staff and visitors? What guidance are you giving staff about handwashing throughout the day? Are they following it? Have you got paper towels? How are they being disposed of? Are you ensuring that all surfaces and handles in your premises are disinfected? What about pens? Cups? Kettles? Have you implemented screening questions when taking a first call to ascertain the level of risk to your collection team? Do you have adequate PPE for staff collecting or handling people who have died? How about body bags? Disinfectant? Hand sanitiser? Are any of your staff members in the potentially most vulnerable groups who are likely to be at most risk from contracting the virus? Or do any staff members have vulnerable family members? How are you minimising their exposure to potential infection? Are you minimising physical contact between staff members and between staff and clients? Are you offering clients the opportunity to make funeral arrangements remotely using email and telephone or video calls rather than physical meetings? What about at funerals? Have you advised staff not to shake hands or physically contact mourners? Are all staff members carrying and using hand sanitiser during the course of the day if they are unable to wash their hands? Are you working closely and communicating clearly with your colleagues to ensure everyone is ok, both physically and mentally? What more can you do?
• Stay as up to date and informed as possible. The situation is changing minute by minute.
• Connect with other local funeral companies. Louise Winter, of Poetic Endings, one of the GFG Recommended funeral directors, has set up a support network for London based companies to offer support and resources to each other and to enable a co-ordinated and efficient response to any crisis. Do the same in your area.
• Plan ahead for the possibility that public gatherings may be prohibited. This move could potentially involve gatherings for funerals – either those where there are large numbers of people, or, in the worst-case scenario, completely. Client expectations will need to be managed sensitively and honestly.
• Consider recommending that clients use their own cars to travel to funerals rather than offering limousines. Requiring a staff member to drive up to six people in close proximity in a limousine could be seen as asking individuals to undertake an unnecessary risk.
• Stay in contact with your local crematoria and cemeteries. Some crematoria are already putting restrictions in place such as removing hymn books, prohibiting the carrying of coffins on shoulders and not permitting those who are self-isolating to attend funerals.

We will do our best to relay official advice for the funeral sector on this blog as we access it, however for the time being, common sense dictates that we recommend everyone takes the utmost care to minimise their potential exposure to Covid-19. Vulnerable members of our society need the rest of us to take as much care as we can.

NB Until such time as we consider it safe to do so, the GFG will be carrying out all our business remotely. Accreditation visits will be done using video calls rather than in person, and we will not be attending any conferences or mass gatherings for the foreseeable future.

As everyone should be, we are following the official guidance on hand hygiene, and, because we have highly vulnerable close family members, we are avoiding all unnecessary social contact.

Unprecedented, unknown, unknowable – this is our new normal for now.

The current official guidance regarding people who have died who tested positive for Covid-19 can be found in various documents – links below.

(It is worth noting that some local coroners are issuing guidance requiring that all those who die in the community MUST be brought into a mortuary in a body bag, regardless of whether or not funeral directors suspect the person has had Coronavirus. We have seen copies of these communications.)

The Health & Safety Executive document ‘Managing infection risks when handling the deceased’ advises that body-bags should be used for transporting people who have died from similar notifiable diseases (SARS & MERS) – see pages 48 & 49.

Public Health England’s ‘Interim guidance for first responders and others in contact with symptomatic people with potential Covid-19’ states that personnel handling bodies of those who have died at home where Covid-19 may be suspected should wear gloves and perform hand hygiene – see section 11.

Their ‘Infection prevention and control guidance for pandemic coronavirus’ document is far, far more proscriptive for those caring for people who are alive, recommending that  droplet precautions should be used for patients known or suspected to be infected with COVID-19 in all healthcare settings, and that ‘In all healthcare settings: A FRSM (fluid resistant surgical mask) must be worn when working in close contact (within 2 metres) of a patient with COVID-19 symptoms.’and that ‘Filtering face piece (class 3) (FFP3) respirators should be worn whenever there is a risk of airborne transmission of pandemic COVID-19 i.e. during aerosol generating procedures (AGPs)’

Recommended Personal Protection Equipment for the care of patients with Covid-19 is shown in the table below (page 24 of Public Health England’s ‘Infection prevention and control guidance for pandemic coronavirus’)