March 24, 2020
Question: Are personnel subject to quarantine if they conduct a removal from a contaminated environment such as a house or nursing facility that is under quarantine? Does wearing proper fitting personal protective equipment (PPE) serve as a barrier to protect the person doing the removal and negate the need for quarantine?
Answer: If the team doing the removal of a suspected or confirmed case of COVID-19 wears all the proper PPE equipment (see list below), then this should serve as a barrier and negate the need for the removal personnel to be quarantined.
Here is a suggested process of how to handle the removal of a quarantined death. PLEASE NOTE that local and state agencies may also require additional procedures. These suggestions serve as a guideline only:
- The family should be prepared by the funeral home that upon arrival of their staff at the place of death they will be donning their full protective equipment before entering the residence and that no family members should meet them outside upon arrival. We must ensure no family members who are present greet the staff outside or before they are “suited up” in their PPE.
- Upon entering the residence, best practice would be to request family to respect the “social distance” recommended of 6 feet (2 meters). The removal team should refrain from unnecessarily touching any surface inside the house. When dealing with the remains, make sure you spray the remains down with a strong disinfectant and cover the facial area with a cloth soaked in disinfectant before moving the remains. The remains must be placed inside a body pouch and upon closing the pouch the outside of the pouch must be sprayed with disinfectant. Once the remains are closed and, on the gurney, remove yourself and remains from the house.
- Once the remains are loaded into the removal vehicle and the family have returned to inside the residence, then the PPE may be removed following proper procedures of doffing equipment. The used PPE must be bagged in a bio-hazard bag, sealed and disposed of accordingly. Remember, when returning to the funeral home with the remains the gurney should not be touched until you have once again donned appropriate PPE. It is heavily suggested that the entire removal vehicle and gurney be disinfected before next use.
- Remember that the PPE we wear is to protect us and keep us from exposure and reduce risk of contamination. If PPE is properly worn, there is no reason for us to have to go into quarantine after making the removal of a quarantined death. If that were the case, every healthcare professional caring for the sick in this situation would have to stop working and self-quarantine.
Suggested list for proper PPE for a safe removal:
- Disinfectant spray (know your product and its effectiveness to work on COVID-19)
- Full Tyvek suit
- N95 mask or greater
- Facial shield or goggles
- Long cuffed gloves
- Shoe covers
- Bio-hazard bag (for disposal of PPE when completed)
- Hand sanitizer to disinfect hands prior to removal of N95 mask
Donning and doffing PPE by CDC standard – https://www.cdc.gov/HAI/pdfs/ppe/ppeposter148.pdf