In New York City, the coronavirus epicenter of the country, the infrastructure for funerals and burials has been stretched to its breaking point, bringing more trauma to families already in grief.
Friends and family members of the deceased sometimes wait days for burial and go to funeral services during which they cannot embrace each other, if a ceremony is held at all.
Many funeral directors and cemetery workers in New York City told MarketWatch they are dealing with at least double their normal workload, and worry about contracting the virus from the bodies they handle.
Arsenio Lopez is the director of the Borinquen Memorial Funeral Home in Bushwick, Brooklyn, and a Vietnam veteran, who likens coronavirus in New York City to wartime.
“I thought I would never see that many body bags in my life, and I’m seeing them now,” Lopez told MarketWatch.
A long wait
As of Monday, 2,738 people have died of the disease in the five boroughs, according to the New York City Health Department. The state had its highest death toll yet on Monday, as 731 people succumbed to the virus.
The situation is so dire that New York City Councilman Mark Levine, a Democrat who represents parts of upper Manhattan, caused an uproar when he tweeted that the city would start using parks for “temporary interment.” He later retracted his statement, and Mayor Bill de Blasio said there would be no mass interments in public parks.
The mayor added that if it became necessary, Hart Island, off the coast of the Bronx, is a place that the city has historically used for mass burials. They are “exploring” using it for temporary burials, his office said.
To date, to help deal with the overflow of coronavirus fatalities, makeshift morgues, many built out of refrigerated trucks, have been sent to hospitals around the city. As they fill up, so do funeral homes, crematoriums and cemeteries.
Funeral directors lament long wait times for the medical examiner to release bodies into their care. Some said that before coronavirus, it took an hour or two to get permission, now they said, it can take up to 24 hours.
The majority of funeral homes have no refrigeration, and many funeral directors are choosing not to embalm bodies because of possible exposure to coronavirus.
With longer wait times for burial and cremation, there is a fear of potentially leaving the bodies to linger at funeral homes.
With only a handful of crematoriums in New York City, restrictions have been loosened to allow them to operate 24 hours a day, seven days a week, The Wall Street Journal reported. Even then, the wait time for a body to be cremated is currently more than two weeks, according to funeral and crematorium directors.
“At a particular point in time, it’s going to be a health concern,” said Joe Manno, a funeral contractor in Brooklyn who works with different funeral homes, referring to bodies that need to be cremated or buried.
Like hospital workers, many in the New York City funeral industry fear they will fall ill with coronavirus, particularly because they handle bodies that could still be carrying the virus, and are struggling to get personal protective equipment, or PPE.
Alexander Kurbatsky, director of Big Apple Funeral Services, based in Gravesend, Brooklyn, said he wears a mask nearly all day, leaves his clothes in the garage when he gets home, and immediately showers and disinfects.
“I have to stay somewhat healthy or try to stay, you know, COVID-free, to help the next family, because if I’m not out, if I’m in isolation or God forbid if I’m in the hospital under the ventilator, I’m not going to be able to help anyone,” he said.
Among funeral directors, there is a reticence to embalm people who have died from coronavirus, as it is currently unknown how long the virus lingers in a body after death. Some will still embalm, but wear extra protective equipment.
The World Health Organization does not recommend embalming people who have died of COVID-19.
The Centers for Disease Control and Prevention does not explicitly say this, but urges the use of PPE and standard precautions “to prevent direct contact with infectious” bodies.
There are also fears among funeral workers that coronavirus deaths are being underreported.
Funeral director Andrew Anastasio, of the B Anastasio & Son Funeral Home in Williamsburg, Brooklyn, said he had a case where a doctor signed the death certificate, but didn’t mention the deceased had coronavirus. He was only told so by a nursing supervisor.
“When people die at home, and they never got the test done, they’re not considered COVID,” said one funeral director who asked not to be named. “But when you talk to the families, they say ‘Oh yeah, my father had a fever for three days and then he couldn’t breathe and then he passed away.’ But it’s not a confirmed case because he didn’t do the test.”
In a news conference Tuesday morning, when asked about the possibility that at-home deaths from coronavirus were being undercounted, Mayor de Blasio said that he assumed most were coronavirus related.
“The first thing we are focused on is saving the next life,” de Blasio said. “So we do want to know the truth of what happened in every death that happened at home, but I think we can say at this point, it’s right to assume that the vast majority are coronavirus related.”
A new normal
Different funeral homes have different procedures during coronavirus—some are holding small wakes of under 10 people, while others are holding none and only dealing with direct burials and cremations. Many funeral homes are so overloaded that they have had to turn families away.
Some cemeteries in the city have set up their own protocols as well, limiting the number of people who can attend funerals, or the number of funerals held each day, in an effort to maintain social distancing.
The rituals associated with funerals have also been sharply curtailed, as many churches, temples and other religious sites are closed.
Julie Bose, president of The Evergreens Cemetery in Brooklyn said that they are arranging twice the number of funerals they normally would, capping the number of daily funerals at eight, and attendance at 10 people or fewer. If family members want to see a casket lowered into the ground, they can do so from the road next to their vehicles. The cemetery employs 16 full-time gravediggers who all wear masks and gloves.
“My staff comes into work every day and they’re amazing,” Bose said. “At personal risk to themselves and their own safety and their own families.”
Green-Wood Cemetery in Brooklyn usually holds four to five funerals a day. Now they’re doing six to eight, though some days there have been as many as 10, according to cemetery President Richard Moylan. However, the real escalation has been cremations. Where before they did around 10 cremations a day, they’re now doing 20 and more. On April 6, the next available cremation date was April 22.
“I’m just hoping our staff stays healthy. And I’m hoping we can continue to make all of the in-ground burials on a timely basis,” Moylan said. “We want to do anything to make this as easy as possible for families.”
Staff in the crematorium wear hazmat suits when they handle bodies. Wooden caskets are slowing down the time it takes to complete a cremation, as they take more time to burn than cloth or pressed wood caskets. Green-Wood is running its crematorium 16 hours a day, with staff working double shifts, but its wait time is still longer than two weeks.
Most funeral attendees, according to Moylan, are self-policing, standing at a distance from each other, if they are able to come to the funeral at all.
At the same time, many families are waiting until a later date to hold religious and full funeral services, when social distancing is no longer required.
A dark future
Many funeral directors say the strain on the funeral infrastructure as a whole during coronavirus is more severe than other disasters the city has experienced, like 9/11 or the AIDS epidemic in the 1980s.
The next few weeks could be even worse than the last, as the death toll continues to rise.
“We’re in uncharted waters,” Anastasio said. “I’ve been doing this 40 years. Never was a period like this.”