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Note: This story focuses on the funeral industry. If you’ve experienced a loss during the pandemic, it might be difficult for you to read. But this story is an important one to tell: To date, there have been 298,266 deaths caused by COVID-19 in the United States. And these deaths are disproportionately affecting certain communities, including Black, Indigenous and Hispanic communities. Funeral workers are an important part of every community. They take care of our loved ones after death, and help us to say farewell. But they’ve been challenged by the pandemic, too. Here’s their story.
This will be the first holiday season that Garnice Robertson and her family spend without her mother. Their grief is further complicated because many family members were unable to say a final goodbye. When Robertson’s mother, Georgia Mae Clardy, caught COVID-19 in April at the age of 89, only one person was allowed to visit her for one hour each day.
When Clardy died from COVID-19, instead of a traditional funeral with over 150 people attending, there was a graveside service in Kansas City, Kansas with about 10 people — masked, gloved and socially distanced. Others watched from their cars. There was no viewing.
“This was nothing like a regular service where you can gather together with family, friends and loved ones,” Robertson said. “My family struggles because we couldn’t open her casket for the graveside service. That will be with us forever.”
As families struggle with COVID-19 precautions altering how they can safely grieve loved ones, funeral industry workers are facing increased hazards handling infectious bodies and enforcing safety protocols to keep the living alive.
“It’s hard to do the big, elaborate services that were once done, and that’s what families look for,” said Gwendelrae Hicks, owner of the Northern Star Mortuary in Kansas City, Kansas, where Robertson made her mother’s funeral arrangements.
“We try to come up with accommodations that we can in a manner that is very respectful and dignified.”
Risks of COVID-19
As the number of deaths rises, funeral homes are seeing increased workloads and stress. COVID-19 hits every community differently. There have been 4,514 total deaths from COVID-19 in Missouri and 2,072 deaths in Kansas. Some cities, like Springfield, Missouri, have turned to mobile morgues in the last month as bodies await either investigations from medical professionals or pick-up by funeral workers.
In Kansas City, COVID-19 deaths have disproportionately affected the Black community. The COVID-19 death rate for Missouri’s Black population is higher than any other racial or ethnic group. In Kansas, only indigenous populations are experiencing a higher death rate. In both states, the death rate for Black people has climbed throughout the pandemic.
“You can have one town and a funeral home that is just swamped, then there’s other areas of the state that aren’t seeing as many deaths,” said Pam Scott, executive director of the Kansas Funeral Directors Association. “Sometimes it comes in waves in certain areas. It just depends on the part of the state you’re in.”
While morticians always have to take precautions while preparing bodies, there are extra safety concerns for those who had COVID-19 when they died since tissues and blood can still contain the virus after death.
At the beginning of the pandemic, Hicks said most morticians didn’t embalm bodies because so little was known about the virus.
“She talked with our family about the risk of opening the bag,” Robertson said. “It was basically something we lived with, whether we liked it or not.”
Hicks didn’t start embalming COVID-19-positive cases until August, and said she is still leery of it.
“Sometimes it can be overwhelming,” Hicks said. “Families wanting to see their loved ones even though they had COVID and not understanding that we are putting ourselves at risk.”
Although guidelines from the Centers for Disease Control and Prevention say COVID-19 positive bodies should be double bagged when sent from the hospital to the mortuary, Hicks says she has had several come to her business that weren’t.
When Hicks embalms a body, she wears a face mask, face shield, gloves, a smock, shoe covers and head covers. She said the personal protective equipment she wears hasn’t changed, but her suppliers have been on backorder and it can be challenging to obtain the gear she needs.
PPE shortages were a big problem at the beginning of the pandemic, but most funeral home directors have since started stockpiling inventory, Scott said. Funeral home directors have never had to face something like the shortage before, she said.
Hicks charges around $700 extra for COVID-19-positive cases with embalming, as she needs to dispose of the embalming fluid and PPE afterward to make sure there is no cross-contamination. After embalming, she disinfects the entire prep room and all of the instruments she used.
“It is very stressful because I have grandchildren, I have children,” Hicks said. “You have to make sure you’re very cautious with what you’re doing in the prep room, with handling needles and instruments and making sure you’re not pricking yourself.”
Enforcing COVID-19 restrictions
Funeral directors also have to work diligently to try to stop the spread of COVID-19 while meeting with their clients and during funeral gatherings — a new responsibility.
Offices at Northern Star Mortuary are open 24/7. Families with a loved one who died can show up at any moment. Hicks said it’s important to meet with families face-to-face, while wearing masks, because they need to be guided through the process of arranging the funeral. Information to collect. Contracts to sign.
Hicks has done a few meetings using Zoom and faxes, but for the most part her customers would rather meet in person.
However, Scott said many funeral directors have moved to meeting with families virtually, and that it’s especially necessary when making arrangements with family members who have COVID-19.
Services families choose have changed during the pandemic. Most people used to have a two-hour viewing and then a service, Hicks said. Now, families usually have just an hourlong viewing or memorial service.
“There is a time limit,” Hicks said. “We are not trying to rush families, but trying to keep them safe.”
Without the option of a larger funeral, more families are turning to cremation, which can allow them to still have a viewing but without embalming. Hicks said about 75% of families are choosing cremation now.
Cremations have been on the rise in Kansas partially due to the nature of COVID-19, but also because of limited funeral attendance. Cremations can also be cheaper, depending on the options that the family chooses for the service and with the cemetery. Hicks said that while burial options start with a minimum around $5,000, cremations start at around $3,000 with a service, or $1,195 with direct cremation.
“Even when a cremation takes place, oftentimes families still want the body prepared because many people have not been able to say goodbye to loved ones. They’ve been in the nursing home or hospital. The family hasn’t been with them when death occurs,” Scott said.
People are also delaying funerals to have memorial services at a later time, Scott said. This is especially true of COVID-19 deaths, when many times the family has also been exposed and is quarantining.
According to Hicks, the biggest challenge funeral directors face during the pandemic is enforcing COVID-19 safety regulations. In Wyandotte County, there is a mask mandate in place for all indoor and outdoor public gatherings. At funerals, people must maintain a distance of 6 feet from anyone who lives in a different household. Under the most recent COVID-19 restrictions for the county, large gatherings of more than 10 people are prohibited.
“People just really don’t want to comply with wearing the mask, and when you ask them to put the mask on, they’re offended,” Hicks said. “But you know, it’s offending when you’re not wearing your mask, because we’re all just trying to stay safe.”
Getting families and friends to stand apart from each other in a time where emotional support comes from physical affection also isn’t easy.
“It is so traditional to want to hug and kiss, just greet each other in that manner. Now we have families that really don’t want to comply,” Hicks said.
Figuring out social distancing for services that take place at churches is especially tough, Hicks said, because some of them are small enough that 6 feet of separation isn’t fully possible. She tries to collect information from everyone attending funeral services so she can reach out to them in the event of a COVID-19 exposure, but many people don’t want to share their information.
Funeral changes affecting families
Hicks has noticed how her customers grieve has changed during the pandemic.
“Just seeing the looks on their faces, knowing they have other family members that can’t attend — it’s heartbreaking,” she said. “COVID has ruined our loved ones having the funeral service that we want them to have.”
Working as a funeral director is a calling, Hicks said, and she does her best to accommodate and guide families within the rules. Some funeral homes are turning to more creative, socially distant ways to help their customers mourn, like drive-by viewings or online registry books.
Streaming of funeral services has increased, Scott said.“Some (funeral homes) scrambled to make that possible to families if they hadn’t had it before,” she said. “They’re trying to provide meaningful services for families that will help them through their grief.”
For Garnice Robertson, friends found a unique way to support her while she was mourning — her line dance group visited her outside her home, stood 6 feet apart and danced for her.
But nothing will be able to replace the regular funeral service her family wanted. Months later, they are still unable to have a memorial because of surging COVID-19 cases and the resulting restrictions.
“I can only pray for families that have to deal with this,” Robertson said. “Their hands are pretty much tied.”