While Canadian health officials have extensive plans to ensure people survive a future influenza pandemic, they've also made macabre recommendations for the nation's funeral homes for those who don't.
"In a pandemic, each individual funeral home could expect to handle about six months work within a six- to eight-week period," the Public Health Agency of Canada warns on a web page about the management of mass fatalities during a pandemic flu.
"That may not be a problem in some communities, but funeral homes in larger cities may not be able to cope with the increased demand."
One of its recommendations is that funeral homes make advance plans for what to do if their own staff get sick, including making arrangements with volunteers from service clubs or churches to dig graves.
Storage space for corpses could also be a problem, the agency notes, and it says refrigerated trucks or ice rinks could be pressed into service if needed.
"Funeral service providers, I can assure you, throughout their history, have responded to these sorts of tragedies and would do so again to the very best of their ability," says Allan Cole, a board member with the Funeral Services Association of Canada and president of MacKinnon and Bowes, a company that provides services for the funeral industry.
But finding a funeral home that's willing to talk about their own pandemic planning is difficult. The Canadian Press reached out to numerous funeral homes in several Canadian cities and asked whether they were prepared for a pandemic, but not one returned the calls.
Cole has been serving on committees for about a decade that deal with infectious diseases and how they affect the funeral profession.
I don't think many (funeral homes) really embarked on any sort of a program to upgrade their inventories for some sort of potential requirement.Allan Cole
He says there is a lot of interest in planning when diseases such as SARS or Ebola are in the news, but it wanes when pandemics fade from the headlines.
Cole says it's also difficult for funeral homes to stock many of the extra supplies they would need if business unexpectedly picked up.
"Anything that you buy and save for some horrible eventuality, these are items that have a shelf life. You couldn't buy, for instance, latex gloves, put them on the shelf and expect 15 years later that they're in good condition. They simply aren't," Cole says.
"Subsequently, for a private enterprise to go and undertake that sort of an investment for a potential community requirement would be hugely onerous and, as a result, I don't think many really embarked on any sort of a program to upgrade their inventories for some sort of potential requirement."
Mourners could also be contagious
The public health agency's 2015 guide for the health sector on planning for a pandemic notes that historically, pandemics have occurred three to four times per century. However, it says there is no predictable interval.
It says the last four pandemics demonstrated that population impact can vary from low to high.
The agency says that during a pandemic, some families could experience multiple deaths at the same time, straining their financial resources for high-end funerals. It recommends funeral homes stock an extra supply of inexpensive caskets.
Diseases like Ebola can be spread through direct contact with the bodily fluids of victims or corpses. During the Ebola epidemic in West Africa, traditional funerals, in which mourners touch the body, were a source of virus transmission.
The Canadian agency says special infection control measures are not required for the handling of people who die from influenza, as the body is not contagious after death. But mourners who attend funeral homes could be contagious, and it says it would be up to provincial health officials to decide if restrictions are needed on the type and size of gatherings.
The agency notes the average attendance at a visitation in Prince Edward Island is 1,000 to 1,400 people.
No special vehicle or driver licence is needed for transportation of the deceased, the agency states.
"Therefore, there are no restrictions on families transporting bodies of family members if they have a death certificate."
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