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Funeral director Poppy Mardall is currently organising her first ceremony for a person who died of Covid-19. As with any infectious disease, precautions must be taken — the body could still be contagious so must be buried in a bag, ideally with a mask over the nose and mouth — and those handling the body should be in personal protective equipment (PPE).
With the death toll from Covid-19 in the UK currently at 5,373, Mardall says this pandemic means everyone in her industry “is having to step up and adapt”, from businesses like hers, Poppy’s Funerals, to mortuary managers.
These deaths come on top of the approximately 600,000 which the burial and cremation services usually handle a year. It’s been a race to catch up with what’s needed and rapid shifts in practice are going on to cope. The number of people writing wills is increasing; 103,000 were registered in 72 hours last month, and all London boroughs have swiftly made plans to increase morgue capacity.
There are 18,000 body storage facilities in England, Wales and Northern Ireland licensed by the Human Tissue Authority (HTA), according to the organisation’s 2019 report, and 7,000 contingency spaces. Funeral directors have more capacity.
The HTA is working with the Government on plans to expand — there are already two more mortuaries at the new Nightingale Hospital at the ExCeL centre, where 200 army engineers worked 15-hour shifts. Westminster coroner’s court has expanded its mortuary from 102 bodies to 170 and a temporary one on Wanstead Flats is being built. The Mayor of London says there will be more, it’s just a matter of where.
Portakabin.com has been enlisted to provide extra space. Some will be on council or Ministry of Defence land but there are sensitivities around people being uneasy at these new facilities being near their homes.
“Plans are being developed based on possible additional deaths which will create pressures across the capital,” says a spokesperson from London’s Strategic Co-ordination Group. “Several suitable sites have been identified to host additional mortuary space and they will stay in place dependent on need, with the plans under constant review, scaling up or down as required.”
Italy, which has been cited as an example of where we could be in a few weeks if we don’t take precautions, has been caught out by not having adequate provision for deaths. Videos have been shared of Italian army trucks taking coffins to remote cremation sites. New York is running out of morgue space and there are makeshift ones outside hospitals and in Central Park. Over here, the Government says it is “working with communities to undertake contingency planning so we can ensure the public are kept safe, and any tragic loss of life is handled with the utmost respect and care”.
Before a body can leave the hospital for burial, cremation or other method it is kept refrigerated at between two and four degrees centigrade in a morgue to delay decomposition. King’s College Hospital, which has one of the bigger capacities, is used to about 120 bodies a month coming into its mortuary, where they are kept in fridges with names and dates of death.
To streamline the process and free up mortuary space, hospitals have made changes to the paperwork required so that bodies can be released faster — more people are now authorised to register deaths, including funeral directors. Local authorities are now allowed to direct the process. Most funeral directors have cancelled leave, says Terry Tennens, chief executive of the National Society of Allied and Independent Funeral Directors, “to ensure all hands are on deck to cope with the unseasonal increase in deaths”.
This has come at a time when the funeral sector in the UK is already under scrutiny. The Competition and Markets Authority is investigating the rise in cost of organising a funeral — it has gone up at twice the inflation rate for the last 14 years (funerals usually cost several thousands of pounds) — and the low numbers of crematoria providers. At the same time, says Mardall, “everyone has the right to a funeral and we want to treat each person with the respect they deserve — knowing that the families of the people who have died of Covid-19 will be feeling particularly bruised”. The disease is so infectious that family and friends will not have had the chance to say goodbye in person.
A shortage of PPE is making everyone’s jobs harder. Mardall has 22 masks left for her team. She knows the NHS should be prioritised, but says those dealing with bodies need PPE as well. Body bags are in short supply at some hospitals too. At Epsom and St Helier there are reports of sheets being used instead.
“We have lots of aprons and gloves but it’s the FSP3 masks that we are struggling to get,” says Mardall. “The NHS should be prioritised but we need to know we are getting more soon. If we don’t have sufficient PPE it means it’s harder for families to see their loved ones’ bodies and for us to do our jobs. Those who have died of Covid-19 are still people and we want to look after them in the way we would if they were our children or parents, but we need the PPE to do this.”
On top of this, guidance from the Government on funerals with regard to social distancing measures was not released until last week.
“There’s been a spike in worried clients, irrespective of the cause of death,” says Mardall. “There has been no real guidance on what a funeral can or should be — so organisations are interpreting that themselves, which is confusing for the public. Crematoria are interpreting the rules about large gathering themselves, but they don’t know whether to limit numbers to five, 10 or 25, and the funeral sector is struggling with this. It worries me because we want to do our best. A funeral is an essential thing and we should be facilitating that. Isolation is not what the majority of people need when grieving.”
They have done online ceremonies, with families reading out messages on video calls, listing people who wanted to be there, showing pictures drawn by children. Mardall is thinking about the concept of delayed grief. “People may be hit hard later. We are telling people they can have the cremation or burial now and hold a service later with more people.”
Despite everything, Mardall is confident that “in London we have the facilities to deal with this”.
She adds: “There is a lot about the sector that needs to modernise but funeral directors are stepping up with what they have. The pictures of morgues shouldn’t be alarming, it’s just refrigeration. Our job is to balance responsibility with still allowing this crucial experience, and do everything in our power to allow small groups of carefully thought-through people to have this rite of passage.”
