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Coroner orders sweeping changes to avoid ‘sad scenes’ like those in Italy, U.S.

Ontario’s chief coroner says the COVID-19 pandemic is forcing his office to make major changes to how hospitals and funeral homes deal with the dead.

Grieving families whose loved ones die in hospital will now have just one hour to decide on a funeral home, or up to three hours if the death occurs in a long-term care home.

The coroner’s office has also ordered changes to how death certificates are issued, how autopsies are performed, how bodies are collected from morgues and how they’re prepared at the funeral home.

The changes, which came into effect last week, will apply to most deaths in Ontario, not only to those resulting from COVID-19.

“We’re making big decisions that have impacts on people. We are building this on a foundation of respect, trust and dignity for the deceased person … but there’s no question it impacts families,” said Dr. Dirk Huyer, chief coroner for Ontario.

‘I feel really sad’

Huyer said the goal is to move “everything more quickly” as the coronavirus continues to reap its deadly toll in the province’s hospitals and nursing homes.

Earlier this year, one health-care workers’ union sounded the alarm because bodies were being kept in areas outside the morgue at The Ottawa Hospital.

Dr. Dirk Huyer, Ontario’s chief coroner, said he’s ‘saddened’ to have to ask grieving families to make quick decisions about funeral services for their loved ones. (CBC)

Huyer said funeral homes have a “substantially greater” capacity to store bodies than do hospitals and long-term care facilities. The changes being made now are to ensure there aren’t “storage capacity” challenges down the line, he said.

Before the new protocols, Huyer said some families would “take some time to think about which funeral service they’d like to utilize.” Now there just isn’t time.

“When I talk about this I really feel sad because there’s so much expectation that we put on the families to make decisions promptly at a time of significant loss and grief,” Huyer said.

Death certificates in the province will now be issued electronically and directly to funeral homes, eliminating the need for funeral home staff to collect paper copies from hospitals.

Nor will funeral home staff enter hospital morgues; instead, the bodies will be brought out to them in a body bag which will then be sanitized before being loaded into the hearse.

“We’re also recognizing the worldwide shortage of PPE, personal protective equipment, and so the funeral service providers are actually not entering into the hospitals, or entering into the long-term care homes, to reduce any chance of infection,” Huyer said.

Pause on autopsies

Autopsies will no longer be performed on someone who is suspected to have died from COVID-19 unless there is another factor “of great significance,” such as a homicide.

“We don’t know if there is a potential way that transmission could occur after death,” Huyer said.

Changes have also been ordered at funeral homes, according to one funeral home director who spoke to CBC.

“We’ve limited the number of staff who can go into the prep room,” said Scott Miller, general manager at Hulse, Playfair & McGarry Funeral Home in Ottawa.

“We have to limit how many people go in and help transfer the body onto a table, and how many do the preparation, and those people are somewhat isolated to that room for the entire day.”

Scott Miller of Hulse, Playfair & McGarry said shortages of personal protective equipment are a concern within the funeral industry. (Jean Delisle/CBC)

Miller said that cuts down on the possibility for infection while a body is being embalmed, and also reduces the use of precious personal protective equipment.

“There’s definitely shortages [of PPE] in the funeral homes. And I’ve spoken with my colleagues across Ontario, or really across Canada, and it was a challenge for us to locate enough PPE to continue to operate. And it still is — we have to be very careful with how much we’re using,” Miller said.

Recommending cremation

Funeral homes are in the best position to handle remains that potentially pose a health risk, according to the Bereavement Authority of Ontario (BAO), which regulates licensed funeral establishments.

“[Funeral home workers] are quite accustomed to protecting against infection and viruses on a regular basis … those same measures are in place now. Obviously there’s an added onus on that these days,” said the BAO’s David Brazeau.

Brazeau said the BAO is recommending families consider cremation right now, but said embalming “is still a perfectly legitimate … way to go in terms of the current pandemic.”

He said the authority is confident the new measures will spare Ontario the “sad scenes” that have been playing out around the world.

“We are not going to see the scenes that we’ve seen in Italy, or in the United States, in other parts of the world, where loved ones, the bodies of loved ones, are in essence being stockpiled in arenas and community centres and so on. And that’s not going to happen here because of the proactive measures we’ve put in place,” Brazeau said.

Ontario’s chief coroner said that is the ultimate aim of the new measures.

“The hope is with all of the hard work that the health-care providers are doing … that our plan really isn’t going to be required any more than it is. But we wanted to start now,” Huyer said.

CBC

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