kevon.felmine@guardian.co.tt
It’s the second year of a pandemic Christmas, when hundreds of families will be celebrating the season without loved ones because they died from COVID-19.
Trinidad and Tobago has seen a significant surge in COVID-19 cases over the last two months. The strain on the nation’s hospital mortuaries and funeral agencies has been unprecedented.
Death visits a family’s home almost every hour on the hour, with statistics pointing to an average 23 deaths daily.
It has become not only an emotional burden for families but also a financial one.
The surging death rate has kept funeral homes buzzing with activity. They are inundated with COVID-19 bodies daily which they must prepare meticulously for cremation or burial.
The popular consensus on the ground for some time now is that funeral homes have been raking in the dough.
But directors of at least two funeral homes that Guardian Media spoke to dismissed these claims. In fact, they say it is the opposite, as caring for COVID-19 victims has significantly increased their expenditure, with profits virtually non-existent.
The starling rates of COVID-19 deaths have pushed these funeral homes’ storage to the brink.
Based at Coffee Street in San Fernando, JE Guide Funeral Home & Crematorium was one of 22 funeral agencies that were given the green light to handle the final rites of COVID-19 victims.
Beverley Guide-Williams, the director of the home, said handling COVID-19 victims piqued her curiosity and she wanted to learn more.
In September 2020, armed with all the knowledge she acquired, J.E Guide spent a sizeable chunk of money to install new refrigerators to store COVID-19 corpses separate from other bodies to avoid any contamination.
The company also purchased an electrostatic machine to sanitise surfaces and trained employees to ensure they were up to speed with all the requirements as it pertained to handling a COVID-19 corpse. The funeral staff uses the electrostatic machine at least twice a day, especially when a person who died had COVID-19.
The bundle of new equipment already added to the existing stock has also pushed the funeral home into increased overhead costs.
Sticking to guidelines and recommendations laid down by the Ministry of Health for handling COVID-19 bodies is important and risking anything else could lead to a funeral home losing its license.
Guide-Williams explained that retrieving a COVID-19 corpse is not a simple process.
“You have a Tyvek suit, and you have to double glove. You have to wear a whole face mask. You must use the designated vehicle. We also have to know that when you touch the refrigerator, it has to be clean after, and then we had to look at taking off one pair of gloves when you touch it and then come into the vehicle and take off the suits,” Guide-Williams said.
The company had to train the employees before taking on dangerous jobs. Guide-Williams explained that funeral homes had no choice but to pay increased prices during the pandemic with numerous protocols in place. There were also hazard payments to employees.
According to the Health Ministry’s guidelines, funeral homes must have the required supplies and Personal Protective Equipment (PPE) for removal staff. These include goggles, N-95 or equivalent masks, long sleeve gowns, non-sterile nitrile gloves, soap and water, standard body bags, disinfectant-soaked absorbent cotton, safety boots, spray bottles containing disinfectant, biohazard bags, impervious plastic bags and other personal protective equipment that staff require.
“Our overheads have tripled and it is even going fourfold right now. And there are a lot of hidden costs that people are not looking at. We look at the Tyvek suits. We look at all the machines used for sanitisation. We are looking at the increased sanitary supplies.”
Guide-Williams said some local suppliers took advantage of the pandemic. She claimed when JE Guide needed supplies, the prices increased.
The funeral home has an average of 50 bodies at any time and tries never to go overcapacity, she added.
Dass Funeral Home, which operates in Chaguanas and Marabella, meanwhile has ample storage and access to more facilities if the need arises.
Director Carlyle Mulchan says while the ministry mandates burying COVID-19 victims in an approved cemetery or incinerating at a crematorium, it is not always possible. Sometimes, a victim’s family is isolated at home or quarantined in the parallel healthcare system. In some cases, Dass had to keep corpses between five to 20 days before a funeral.
“I have a wife who died from COVID-19 and the husband is in Augustus Long. The husband does not know the wife died and it may be touch and go even to tell you to relay that information,” Mulchan said.
Hindus traditionally cremate their dead and sometimes families have to wait for the availability of crematoriums, as the ministry restricts open-air pyre cremations for COVID-19 victims. Dass does not get many requests for burials, creating schedule and storage congestion.
Guide-Williams said because of this issue and the increased volume of funerals, JE Guide could take up to 12 days to cremate a body. She explained that the incinerator can cremate four corpses in a day but must be switched off for at least 24 hours after significant use.
Mulchan said one way to ease the congestion is to allow open-air pyre cremations at various cremation sites. He said medical experts locally and abroad found no difference between burial and incineration at a crematorium or cremation site once done within proper guidelines. He said Dass would clear its storage within two weeks if the ministry allows cremations of COVID-19 victims at these sites.
“Right now, if someone dies of COVID-19 and they want to use a crematorium, you cannot get anything this week. You have to wait until mid-next week to get Belgrove, Guide, or Trincity. The St James crematorium has said clearly that they are not doing COVID-19 funerals. So everything is backing up with that spike in deaths we have seen.”
Cremations will also decrease the cost by approximately 50 per cent, as it eliminates the use of chapels for families who prefer traditional funerals and who are struggling financially. Mulchan said Dass offers its chapel at the Marabella branch for free and he says many priests, pundits and imams are not charging for services.
He said a funeral at a cremation site could cost between $8000-$10,000, while a crematorium could be $15,000 and up.
While it is costly to lose someone to COVID-19, saying goodbye to a loved one is even harder, especially when you cannot do it properly.
Seeing your dead child or parent at a hospital mortuary after they die from COVID-19 will be the last time you get that opportunity.
The ministry’s guidelines state that when a person dies, health personnel must wrap the body in the underlying sheet, only leaving the face exposed.
They then transfer it to a body bag and take it to a mortuary.
At this point, staff can escort a relative to a viewing area to identify the corpse. The relative must wear a surgical mask and maintain a distance of at least three feet from the body. Staff will return the victim’s high-value items to the family after thoroughly disinfecting them. They then seal the bag and disinfect it with prescribed chemicals. At the funeral home, the body should be kept in a body bag and stored at approximately 4°C.
The ministry prohibits the opening of the body bag at the funeral home. Staff must place it directly in the coffin for cremation or burial and seal the cover.
However, Mulchan said the funeral home has to allow families a small window for identification to provide closure and ensure the bodies in the coffins are their loved ones. There were reports of the wrong corpses turning up at funerals recently, but they were not COVID-19 victims. He said this final identification happens in a sanitised area, where the relative stays behind a glass, similar to the process at hospital mortuaries.
For Imam Fareed Mohammed, who lost his father Sheik Nazrudeen Mohammed last May, it was a terrible experience. To this day, his mother Farida still cannot come to terms that her husband has passed.
“The last time she saw my dad was when he left to go to the hospital. After that, she never ever got to see him again because he came back in a closed box. Sealed,” Mohammed said.
He stood alone at the Tableland Asja Mosque for his father's last rites, as his mother and brothers were in quarantine. Families do not get a chance of a final viewing of the dead in the coffins. They cannot place flowers or the last kiss. The coffin remains sealed.
Sheik Nazrudeen was an imam, marriage officer and friend to many.
Because only five people were allowed to attend the funeral, it robbed them of the opportunity to say a proper goodbye.
Not even the live streaming of the funeral was enough.
Nazrudeen's death underscores how easy it is to contract COVID-19 and how the elderly and those with underlying health conditions are most vulnerable. During Ramadan, as the imam, he and others went to the mosque to pray. One of the brothers was sick and transmitted the coronavirus to the others. Mohammed, 70, a former cardiac patient, went to the Princes Town District Health Facility on May 7. He was suffering from a fever and cough. While awaiting the results of a COVID-19 test, he began struggling to breathe, so doctors ordered his transfer to the Augustus Long Hospital in Pointe-a-Pierre. His blood oxygen level was severely low and began affecting his internal organs. Doctors determined that he needed care at the Intensive Care Unit (ICU). There was a crowded ICU and by 6 pm on May 12, Nazrudeen died waiting for a bed.
With a discount, the funeral cost the family $10,000. An Islamic send-off would usually cost as low as $3,500 to $4,000. Mohammed said the funeral home had to increase sanitisation and use additional PPE, so his family had to pay more.
After Nazerudeen's death, Mohammed witnessed several other funerals in his community. He said families were struggling to bury their dead and were seeking financial help.
“There is an increased cost for the funerals. With the present state of the world and access to equipment, PPE and all that, prices have just moved from what was $150 to $400, $450 for a suit to do burials.”
Mohammed said the Government should consider increasing the value of the funeral grant from the National Insurance Scheme.
Guardian Media reached out on several occasions to the president of the Association of Funeral Professionals of Trinidad and Tobago (AFPTT) Keith Belgrove to get his take on how the funeral industry had been coping with these measures in place to handle COVID-19 victims, but he did not return our calls.
