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New Zealand Funeral Industry - Pandemic Response Plan
NZ FUNERAL INDUSTRY'S PANDEMIC INFLUENZA EMERGENCY PLAN
(Explanation paper)
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40% of all New Zealanders will be infected with the influenza virus
Up to 60% of people will be off work
2% of those infected will die
Expected deaths 33,000 over 8-12 weeks
Week three will see 7,885 deaths
With the peak being in week four, totalling 10,513 deaths
Week five will see 7,885 deaths
"Based on modeling by the Ministry of Health, we are planning for these mortality/morbidity figures, it could be much better or much worse than this, and exact information won't be known until the virus acquires the ability to be transmitted person to person."
The role of a funeral company during the Pandemic is to arrange for the following to occur:
Registration of the death with BDM
Signed identification of deceased
Transfer of deceased from place of death to funeral home
Place deceased into identifiable body pouch
Transfer deceased to local cemetery for burial, or where possible crematorium for cremation.
Provide support for families in the community
While the funeral industry may be operating under emergency laws, we understand more than most, the impact that the Pandemic will have on grieving families. It is for this reason that you may wish to consider employing counsellors to assist in the follow up of families.
You may wish to also consider the following in advance.
The first call from families will come from various sources:
- Family
- Rest Home
- Hospital
- Police
- Friends and Neighbours
While the first call will come from usual sources, this is about where all normality finishes.
This call needs to be dealt with professionally and efficiently.
Upon receiving a First call, obtain the name of the deceased, the callers name, address and phone number and advise them that you will return their call shortly.
This will be necessary if you choose to operate using mobile phones, which will then assist you in keeping your business lines open for incoming calls.
The return call should be made as soon as possible by your staff. It will be important to keep continuity where possible, consider having the same employee ring the family. It will be important for the family to be given correct information at all times, this will give families confidence in your response to their needs.
You may consider employing administration staff during this period.
Returning the First Call
There is much information to inform the family so this call may take some time.
Obtain: Name of Deceased, Place of Death, Date of Death, whether the deceased wished to be buried or cremated, next of kin contact details, and the callers relationship to the deceased.
It is suggested that the family be advised that a transfer of the deceased will happen as soon as possible, however this may take some time to occur. Explain that funeral directors have been advised that deceased persons are not to be transferred to the funeral home until a death certificate has been sighted.
The family needs to be informed that a person will be required to sign an Identification of Deceased Form at the time of the transfer. This person needs to be someone who can positively identify the deceased.
This form should be kept at the funeral home; a registered funeral home funeral case number should be assigned to all documentation for each deceased person. A copy of the identification form should be delivered to the cemetery with the appropriate cemetery forms.
The family should be informed that the funeral home will phone them back later to get the details required for the Registration of Death Form. The family will find it is helpful to have Birth and Marriage Certificates close to the phone when this call is received. At the same time the family can provide us with a death notice if they would like one to be placed in the newspaper.
It is hoped that registration of the death will be done electronically as the normal postal system may not be operating. The printing of death notices may need to be at a later date as the printing of newspapers may be compromised at this time.
You may need to explain that the funeral profession may be working under emergency laws, laid down by the government. There may be a need to explain at this time that it may not be possible to have a cremation; it will depend on the availability of the local doctor. If cremation forms completed by the deceased's medical practitioner cannot be obtained within an acceptable time, or cremation facilities are not operational, a burial will need to occur due to public health issues. The only exceptions to this are when the coroner signs the required forms, or if the Minister of Health step in and make alternative arrangements under the cremation regulation 1973 reg 5 & 7.
Burials are recommended to occur at the closest cemetery and you will need to check in advance what your local cemeteries will be offering in relation to burial options.
It may be illegal for public gatherings during the worst period of the Pandemic. Therefore family members may not be permitted to enter a cemetery until the pandemic emergency is over during this time. City cemeteries may be providing security to ensure that no-one enters a cemetery. This is to ensure that the work of the grave diggers is not interrupted, and health and safety of the workers and public is protected.
It may also be disturbing for family members to see large numbers of burials taking place.
During the early periods of the Pandemic it may be that funerals are being held as usual, however attendance at such funerals would need to be managed. You may wish to consider placing signs outside venues advising those attending that there are risks associated with attending such gatherings.
Be sure to answer all questions the family may have. Check that the person you are dealing with has authority to act. Be calm at all times. Your client families will need to feel reassured and calmness is the very best signal you can give out.
Recommend to families that they do not contact you, but write any questions down and when one of the calls (below) are made, they can ask questions at that point. If you are unable to answer the question, then you will arrange for them to be called back within a defined period by a person within the company who is able to answer their question.
Births, Deaths and Marriages Call - gathering the registration of death details and death notice
Transfer Call - to advise the family when the transfer of the deceased will occur
Burial or Cremation Call - a call to advise that the burial or cremation has taken place
Some Things to Consider:
Lists
Always work off lists. Log first call information alphabetically, to ensure if you need to locate details on a particular person it can be done quickly and efficiently. Never throw away your work sheets. You may need these if there is a problem after the Pandemic Emergency is over.
Consider assigning administration staff to a section of the alphabet, if a call comes in for someone with the surname Smith pass to the person dealing with the P-Z's
Log transfers
It will be important to log transfers in the order that they will be done; you may wish to do transfers suburb by suburb, or by first called first served. It would be wise to use each transfer opportunity to bring back two deceased persons at a time, if this is possible.
If the family are present at the transfer consider leaving a brochure with the family, explaining what is happening.
Identification
Identification of the deceased is extremely important. The deceased should be identified by way of a waterproof label, eg sealed plastic bag, laminated card, or hospital bracelet. The identification should be attached to the clothing/wrist of the deceased at the time of transfer.
You may consider doing this in the presence of a family representative. Families may have concerns about trusting the identification process. It will be important to provide a transparent process that gives families reassurance that the correct person is being buried in the correct plot or being cremated.
Cemetery Communication
Cemeteries may require you to deliver more than one person at a time. Have discussions with you local cemetery as to when they would prefer deliveries from your company. This will allow them time to be ready for a delivery and allow them to prepare the graves and have the identification of plots assigned before you arrive.
You may consider having an arrangement to hire larger vehicles to accommodate more than one deceased person per delivery.
Communication with District Health Boards
It would be wise for each company to have the latest District Health Board's Pandemic Emergency Plan. This will assist with understanding how best to supply support to your community. District Health Boards may offer a different approach to one another, be sure you know what there expectations are.
It would also be wise to maintain close links with the local Medical Officer of Health and Health Protection Officers.
Police Transfers
Police resources will be stretched; you may not be able to respond as quickly as you do now. It may be that the address is supplied and the police will have already left the scene. You may be required to transfer police cases to the local mortuary for completion of the procedures required to ascertain the cause of death. Coroners will be busy, but it is believed that deaths suspected of dying as the result of influenza will be signed off immediately.
Memorial Services
Funeral Directors will be able to assist families with Memorial Services at the completion of the emergency. There will be a great deal of ongoing support to be done in the months that follow and I am sure every year will be marked by memorial services.
Unidentified Persons
The process that will provide the most challenges will be unidentified persons who die of influenza. These people will undergo a DVI procedure. They will probably be released for burial quickly after the requirements for DVI have been obtained.
Identification will be through dental records and DNA, this will probably occur after the pandemic emergency is over. The deceased persons will receive a DVI number and will then be buried. At a point following the pandemic the DVI number will be replaced with the full name of the deceased.
Who Pays
The issue of who pays is in the process of being addressed. The profession has indicated to government that their assistance is imperative as people are being buried under circumstances that are beyond their control. The Government should be expected to pay for the emergency procedures that have been put in place. We are awaiting a response.
Our society will never be the same again.
Plan Your Own Company Response
Tami flu Antiviral Medicine
"The Ministry of Health advises that it is not possible to define the exact usage policy for the national reserve of Tami flu until the nature of any pandemic disease is known. However, current expectations are that Funeral Directors will have access to national reserve medication on the same basis as the general population".
You are encouraged at this time to look at your own company, and consider what you would do, if you had to operate at levels of between 40% to 60% absenteeism.
Consider that 40% of the total deaths will probably occur in your local hospital or Pandemic Influenza facility. The other 60% will occur in the community.
Focusing on transport, staffing, administration, health and safety - who will do what in your organisation? It is likely to be your current annual death rate in 4-8 weeks.
Our businesses need to present, as usual, a solution to a societal problem. If the FDANZ is able to provide professional guidance to the NZ Government Agencies, and we can manage and maintain order in our field of expertise, we will receive praise after the event.
For more information prior to the emergency please free to contact any local district Liaison Officer:
Northland/Auckland - Colleen Morris, John Schipper, Mark Graham
Waikato/Bay of Plenty - Gregory Brownless, Glenda Milligan
Wellington - John Duncan, Paul Dunstall, Bruce Hanrahan
Nelson/Marlborough/Canterbury/Westland - Bevan Hoult, Mark Pattinson, Roy Winton
Otago/Southland - Lyndon Hope, Janice Gray, Michael Ardley
Or Simon Manning, harbour@funeral-link.co.nz
Harbour City Funeral Home
Tel 04 5700-111, Mobile 021 83 00 22
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NZ FUNERAL INDUSTRY'S PANDEMIC INFLUENZA EMERGENCY PLAN
The role of a funeral company during the Pandemic is to arrange for the following to occur:
Registration of the death with BDM
Signed identification of deceased
Transfer of deceased from place of death to funeral home
Place deceased into identifiable casket or body pouch
Transfer deceased to local cemetery for burial,
or crematorium for cremation if requested and if this is possible.
The following check list needs to be completed for each deceased person:
- Obtain the Name of the Deceased, Place of Death, Date of Death, whether the person wished to be buried or cremated, next of kin contact details, callers details.
- Contact family and respond to their needs within the emergency laws that the industry will be operating under.
- Contact Doctor or Nurse who will be issuing Medical Causes as to Death (Doctors Death Certificate and cremation papers if required and if this is possible.
- Contact the family/place of death and advise of the time that the transfer of the deceased will occur.
- Complete the Approved Industry Identification Form
- Call next of kin and obtain Registration of Death details, and obtain death notice information if requested.
- Register Death with Births, Deaths and Marriages
- Notify WINZ
- Contact Local Authority and arrange delivery of deceased to cemetery or crematorium.
- Deliver burial/cremation documents to the local authority
- Notify next of kin that the burial or cremation has occurred.
- Follow up with family upon the lifting of the state of emergency.
Download the Deceased Person Identification Form (PDF format, 53kb)
Numbers of Projected Deaths listed by District Health Board
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Information about Influenza
3 November 2005
What is influenza?
Influenza (the flu) is a very infectious illness caused by a virus. It is much more serious than a common cold and can leave you ill for up to 10 days.
Symptoms of the flu include: a high fever, headache, muscle aches and pains, fatigue, cough, sore throat, or a runny nose. It may take up to three days to feel symptoms after you catch the flu (the incubation period).
Anyone can get the flu. Being fit, active and healthy does not protect you from getting this virus.
Anyone can die from the flu. It kills at least 100 New Zealanders every year, including some young, fit people.
What can you do to prevent getting the flu?
Every year, ask your doctor to vaccinate you against the flu. Because the influenza virus changes frequently, you need to get vaccinated every year to stay immune. Some people can get this free.
Vaccination is free for people aged 65 years and over, and adults and children with certain long-term (chronic) conditions. Your GP will know if you are eligible for a free vaccination.
The flu is very easily spread through coughs and sneezes. If you have the flu, avoid public places and close contact with other people. Always cough and sneeze into a disposable tissue. Put the tissue in a rubbish bin and wash your hands well afterwards.
What is avian influenza (bird flu)?
There are many types of influenza virus, some of which infect birds. These are avian influenza viruses. Very rarely, an avian influenza virus can also infect people. The current avian influenza virus H5N1 has infected some people who have caught it from having close contact with infected birds.
Avian influenza causes severe flu-like symptoms in people and may result in death. It has not been shown for sure that anyone has caught avian influenza from another person.
There are currently no commercially available vaccines that will protect people against the H5N1 avian influenza.
What are the symptoms of avian influenza?
Generally, the symptoms are similar to those for people infected with the flu, although the severity of the illness may differ. Symptoms generally appear three to seven days after exposure and can last up to seven days.
Why are health authorities concerned about avian influenza?
The World Health Organization is worried that an avian influenza virus and a human influenza virus might mix. This could result in a new strain of influenza virus that can be easily passed from person to person. The new influenza virus could spread rapidly around the world, infecting many people. This would be an influenza pandemic.
An influenza pandemic could cause many deaths and could occur at any time. It would not necessarily be a winter illness.
How likely is an influenza pandemic?
It is certain an influenza pandemic will happen one day. The H5N1 avian influenza virus that is found in some countries could become a pandemic influenza virus at any time.
What is New Zealand doing to prepare for an influenza pandemic?
New Zealand has been planning for this for some time. The Ministry of Health has a national pandemic plan, and District Health Boards have local plans. The New Zealand Government, following the advice of the World Health Organization, is stockpiling anti-viral medicine to help reduce the impact of a pandemic on New Zealanders. By the end of 2005 there will be enough anti-viral medicine for about 21 percent of the population.
Is there a vaccine available for a flu pandemic?
The Ministry of Health has a formal arrangement with Australia's CSL Ltd - the only influenza vaccine manufacturer in the Southern Hemisphere - which gives us a guaranteed supply if we need a pandemic vaccine. However, manufacture of such a vaccine can only start once we know the strain of the virus causing the pandemic, and so a vaccine is not currently available.
What could happen in an influenza pandemic?
A pandemic could mean so many people are sick that it will affect workplaces, schools, hospitals and many other services. There would be public announcements on TV, the radio and through other media channels that there is an influenza pandemic. Some workplaces and schools may close. Normal health and other services may not be available for several weeks. You may be asked to care for yourself and others at home.
How can you prepare for an influenza pandemic?
- Talk to your family and friends about health hygiene. Hand washing, and safe coughing and sneezing.
- Make sure you have an emergency survival kit. Plan for having about a weeks worth of essential supplies such as non-perishable food, as well as plenty of fluids. For further information see the Ministry of Civil Defence and Emergency Management website on what to do in a disaster.
- Include paracetamol (for fever) in your home emergency survival kit.
- Have a plan for what you and your family would do if you had to stay at home during a pandemic.
How do you care for yourself and your family during an influenza pandemic?
- Stay home if you are sick and keep away from other people. Avoid visitors and visiting other people.
- Wash and dry your hands after you cough, sneeze, wipe or blow your nose (or your child's nose), use the bathroom or toilet. Wash and dry your hands before you prepare food and eat, and when you are looking after sick people.
- Keep coughs and sneezes covered. Tissues are best. Put the tissue in a rubbish bin.
- Give people who have a fever and/or diarrhoea plenty to drink.
- Give paracetamol for fever. Do not give aspirin to children under 12.
- Try to keep well people and sick people apart.
- Sharing bedding, clothing and utensils may spread infection, but you do not need to wash a sick person's bedding, clothing and utensils separately from the rest of the family's.
For more information, see www.moh.govt.nz/pandemicinfluenza
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